Journal Article

Complications and catheter survival with prolonged embedding of peritoneal dialysis catheters

Pierre Antoine Brown, Brendan B. McCormick, Greg Knoll, Yinghua Su, Steve Doucette, Dean Fergusson and Susan Lavoie

in Nephrology Dialysis Transplantation

Published on behalf of European Renal Association - European Dialysis and Transplant Assoc

Volume 23, issue 7, pages 2299-2303
Published in print July 2008 | ISSN: 0931-0509
Published online February 2008 | e-ISSN: 1460-2385 | DOI: http://dx.doi.org/10.1093/ndt/gfn003
Complications and catheter survival with prolonged embedding of peritoneal dialysis catheters

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Background. Our centre uses a modification of the Moncrief technique of embedding peritoneal dialysis (PD) catheters. We undertook this study to test the hypothesis that catheter survival on PD is a function of the time a catheter is left embedded prior to use.

Methods. Data were retrospectively abstracted from review of patient records of those who received a first PD catheter over a 5-year period. Patients were divided into tertiles based on the number of days between insertion of the catheter and exteriorization to create three equal groups representing early (group 1, 11–47 days), mid (group 2, 48–133 days) and late (group 3, 134–2041 days) exteriorization strategies.

Results. 435 embedded PD catheters were inserted, 349 were exteriorized and total observation period was 5624 patient-months. Time to catheter loss was shortest in group 1 and longest in group 2 (P = 0.04). The overall rate of primary catheter failure was 6% and was significantly different in the three groups (6.9% in group 1, 1.7% in group 2 and 9.4% in group 3, P = 0.04). The time to first episode of peritonitis was longest in group 3 and shortest in group 1 (group 1 versus group 3, P = 0.009; group 2 versus group 3, P = 0.03). Adjusted peritonitis rates, however, were not different between the three groups.

Conclusions. Mechanical complications and catheter loss are associated with the length of time a catheter is embedded. We recommend insertion 6 weeks to 5 months ahead of the need for PD to maximize catheter survival.

Keywords: buried peritoneal dialysis catheter; embedded peritoneal dialysis catheter; infectious complications; mechanical complications; Moncrief–Popovich technique

Journal Article.  3470 words.  Illustrated.

Subjects: Nephrology

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