We hypothesized that catheter infections in continuous ambulatory peritoneal dialysis (CAPD) patients may be reduced with a disconnect system. We examined this theory in 116 CAPD patients over a 2-year period. In CAPD patients who switched to the Y-set (n = 22), the catheter infection rate decreased from one per 13 patient-months to one per 26 patient-months (P = 0.05), whereas the catheter infection rate in matched controls (n = 22) remained unchanged. Patients who began CAPD using the Y-set (n = 36) had catheter infection rates of one per 14 patient-months versus one per 8 patient-months in matched controls (n = 36, P = 0.05). Staphylococcus aureus was the most common cause of catheter infections in both groups of patients. However, Pseudomonas aeruginosa replaced Staphylococcus epidermidis as the second most common cause of catheter infections in the patients using the Y-set. The number of catheters that had to be removed due to catheter infections, mainly those due to S aureus or P aeruginosa, was the same in the Y-set and control groups. We conclude that the Y-set system is associated with reduced numbers of catheter infections, but that catheter loss from catheter infections remains a serious problem. © 1990, National Kidney Foundation, Inc.. All rights reserved.