Objective: To share our 3-year experience with the new, three-cuff peritoneal dialysis (PD) catheter with the low-entry technique and to study its effect on infectious and non-infectious complications as well as its impact on catheter survival.Methods: This is an observational study which was carried out in a university hospital over 3 years. The study involved 153, three-cuff PD catheter insertions in 150 incident PD patients. The study was carried out in our PD center and extended from December, 2012 till January 2016 with a mean follow-up period of 15 months. All patients used automated peritoneal dialysis (APD). Throughout the study, we analyzed survival rate, functionality and complication profile of our new catheter.Results: Four patients had inguinal hernia and 1 had omental wrapping. Catheter migration, however, was 0.0% with our 3-cuff PD catheter using our new technique. A total of 25 catheters had to be removed. Indications for catheter removal were successful transplantation (n =7), hernia (n =4), omental capture (n =1), ultrafiltration failure (n= 2), Psychological causes (n= 4), abdominal surgery (n= 1), severe tunnel infection (n =3), and unresolved peritonitis (n =3). The rate of peritonitis was as low as 0.106 per patient-year equivalent to 1 episode of peritonitis per 112 patient-months. At the end of the study, catheter survival was 91.3%. Conclusion:The low entry-site of our PD catheter seems to prevent catheter migration. The 3-cuffs probably act as an additional safeguard against peritonitis.

There is paucity of studies that discussed the role of peritoneal dialysis (PD) in managing end stage renal disease (ESRD) in sickle cell disease (SCD) patients. The present study compares the outcome of SCD-ESRD patients treated with hemodialysis (HD) or PD. Sixty incident ESRD patients were allotted to HD, (HD group, n=40) or PD, (PD group, n=20). Causes and severity of renal injury were assessed at the time of initiating dialysis. The primary outcome was hospital mortality at 5 years, and secondary outcomes were infection rates, incidents of vasoocclusive crisis (VOC) and acute chest syndrome (ACS), response to erythropoietic agents and improvement of cardiac function. No statistically significant differences were observed between groups in regard to patients’ characteristics. The survival at 5 years was significantly better in the patients treated with PD when compared to HD (75.0% vs. 57.5%, p=0.026). Infectious complications (15% vs 35%, p<0.001), blood transfusion requirements (p < 0.001), VOC (15% vs. 42.5%, p<0.001) and ACS (10% vs. 27.5%, p<0.001) were significantly less in the PD group. Response to erythropoietic agents and improvement of left ventricular ejection fraction (LVEF) were significantly better in the PD group (p = 0.022 and p < 0.001, respectively). This study suggests that there are better outcomes with PD compared to HD in the treatment of SCD-ESRD patients with different dialysis modalities. Key Words: SCD, HD, PD, erythropoiesis, blood transfusion, VOC, ACS, sepsis, cardiac function, survival.