Abstract:
Background: Continuous ambulatory peritoneal dialysis (CAPD) is a potentially cost-effective
renal replacement therapy underutilised in developing countries. Undesirable outcomes in CAPD
patients are often linked to poor knowledge and adherence to treatment practices.
Objectives: To explore patients’ knowledge, adherence to treatment practices and identify factors
associated with outcomes in CAPD patients at a tertiary care institution in Kandy district.
Methods: A cross-sectional study with a concurrent observational component was conducted
among 25 consenting adult patients undergoing CAPD for end-stage renal disease at Teaching
Hospital Peradeniya. A validated interviewer-administered questionnaire evaluated knowledge
using 60 items (total score: 60 points) covering diet, exchange procedure, peritonitis, exit-site
infections, and general. Adherence to practices was directly observed during a CAPD session
using a 60-item checklist focused on exchange procedure and exit-site care. Medical record review
identified outcomes (peritonitis, exit-site infections, and unscheduled hospitalization).
Associations between socio-demographics and outcomes with knowledge and practice scores were
analyzed using Chi-squared test and Mann-Whitney U-test. Association between knowledge and
practice was assessed using Spearman correlation. Significance was assessed at alpha 0.05.
Results: Participants were on average 55±15.2 years, undergoing CAPD for 1.29±0.78 years and
11 were females. Mean±SD knowledge and practice scores achieved were 22.4±5.81 and
52.05±5.40, respectively. Peritonitis, exit-site infections, unplanned hospitalizations, and any
adverse outcome occurred at rates of 0.25, 0.31, 0.28, and 0.84 episodes per patient-year,
respectively. Outcomes were independent of age, sex, educational level, family income,
requirement for assistance, knowledge score, and practice score. The practice score was positively
and significantly correlated with knowledge score (R=0.476, p=0.025). Neither score was
associated with duration of treatment.
Conclusions: Despite satisfactory CAPD practices, knowledge gaps exist, highlighting the need
for repeated reinforcement. Satisfactory practices likely contributed to low levels of unfavorable
outcomes. Bridging knowledge gaps may improve outcomes further.
