Document Detail


Complications and catheter survival with prolonged embedding of peritoneal dialysis catheters.
MedLine Citation:
PMID:  18281722     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
Pierre Antoine Brown; Brendan B McCormick; Greg Knoll; Yinghua Su; Steve Doucette; Dean Fergusson; Susan Lavoie
Publication Detail:
Type:  Journal Article     Date:  2008-02-16
Journal Detail:
Title:  Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association     Volume:  23     ISSN:  1460-2385     ISO Abbreviation:  Nephrol. Dial. Transplant.     Publication Date:  2008 Jul 
Date Detail:
Created Date:  2008-06-30     Completed Date:  2008-09-24     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8706402     Medline TA:  Nephrol Dial Transplant     Country:  England    
Other Details:
Languages:  eng     Pagination:  2299-303     Citation Subset:  IM    
Affiliation:
Department of Medicine, University of Ottawa, Ottawa, Ontario, Canada.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Catheters, Indwelling / adverse effects*,  microbiology
Equipment Failure*
Female
Humans
Incidence
Kidney Failure, Chronic / therapy*
Male
Middle Aged
Multivariate Analysis
Peritoneal Dialysis / instrumentation*,  methods
Peritonitis / epidemiology*,  microbiology
Retrospective Studies
Risk Factors
Time Factors

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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