| Theme |
New Development in CAPD Therapy |
| Title |
SMAP (stepwise initiation of peritoneal dialysis using Moncrief and Popovich technique) changing initiation of CAPD |
| Author |
Chieko Higuchi |
Department of Internal Medicine, Tokyo Women's Medical University Daini Hospital |
| Author |
Takenori Funaki |
Department of Internal Medicine, Tokyo Women's Medical University Daini Hospital |
| Author |
Hideki Nishimura |
Department of Internal Medicine, Tokyo Women's Medical University Daini Hospital |
| Author |
Takashi Naito |
Department of Internal Medicine, Tokyo Women's Medical University Daini Hospital |
| Author |
Tsutomu Sanaka |
Department of Internal Medicine, Tokyo Women's Medical University Daini Hospital |
| [ Summary ] |
SMAP (stepwise initiation of peritoneal dialysis using Moncrief and Popovich technique) is a new method for the initiation of CAPD. After the implantation of a peritoneal catheter into the abdominal cavity, the external segment of the catheter is completely buried and remains in the subcutaneous tunnel until exteriorized after several weeks (or months) post-catheter insertion. When an uninfected fixation of the subcutaneous tissue is obtained, the buried subcutaneous catheter is exteriorized and PD is commenced. The disadvantages are an increase in operation frequency, no information about the abdominal cavity while the catheter is embedded and insufficient access to medical insurance payment for this method. However, there are many advantages to this stepwise operative technique, such as a reduction in catheter infection, achieving optimal dialysis dose within a short period, a higher level of concentration for training, an increase in the acceptance of PD treatment, commencement of PD treatment at the proper point, shortening of the hospitalization stays, reduction of medical costs, and better planned initiation of PD therapy. The number of patients employing this method has increased rapidly, and it has become the standard method for the initiation of peritoneal dialysis. |