Prospective Randomized Study Comparing a Single-Cuff Self-Locating Catheter with a Single-Cuff Straight Tenckhoff Catheter in Peritoneal Dialysis

Sánchez-Canel, Juan J; García-Pérez, H; García-Calvo, Rafael; Pascual, María José; Casado, David

doi:10.3747/pdi.2013.00315

Cited by 13 publications

(8 citation statements)

References 21 publications

(55 reference statements)

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“…The interventions introduced in the included studies were as follows: catheter type/configuration in 17 studies (36%) 14 –30 with the most frequently studied intervention was comparing straight versus coiled intra-abdominal part of the catheters (9 RCTs). Insertion technique in 15 studies (32%) 31 –45 with the most frequently studied intervention open versus laparoscopic catheter insertion (4 RCTs), two interventions in 3 studies (6%), 46 –48 and there were 6 other different interventions in 12 studies (26%) (Supplementary Table 1).…”

Section: Resultsmentioning

confidence: 99%

Peritoneal dialysis access outcomes reported in randomized controlled trials: A systematic review

et al. 2020

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Background: Functional peritoneal dialysis (PD) access is critical to the success of PD therapy. The aim of this review is to describe the spectrum of definitions and methods employed in the measurement of unique outcomes across PD access trials particularly focusing on the outcomes of PD access flow restriction and operative-related outcomes. Methods: Using Cochrane CENTRAL registry, MEDLINE, and EMBASE, we searched for studies restricted to randomized controlled trials (RCTs) involving interventions related to PD access without restrictions on age, language, or publication year. Studies were screened and data abstracted by two independent reviewers. Definitions, outcome measures, and time points of measurements were captured and documented separately. Unique combinations of these variables resulted in reporting the different ways of measurements. Results: Of the 1768 screened studies, 47 RCTs were included among which 817 PD access outcomes were grouped into 7 broad categories. Interventions evaluated in the RCTs were catheter type/configuration ( n = 17), insertion technique ( n = 15), multiple interventions ( n = 3), and other (6 interventions, n = 12). PD access flow restriction (a subcategory of mechanical outcomes) and operative-related outcomes were reported in 91% and 58% of the included trials, respectively. Tip migration was the most frequently reported flow restriction outcome (59% of RCTs) followed by catheter dysfunction (23% of RCTs). Of the components utilized in definition of flow restriction, description of the impaired flow was reported in 37% of RCTs, need for intervention in 42% of RCTs, and presumed etiology of flow restriction in 60% of RCTs. Conclusion: Variability exists in the definitions, reporting methods, choice of outcomes, and analysis of the PD access outcomes across RCTs. Operative-related outcomes remain underreported across RCTs. Outcomes relating to PD access flow restriction were the most common complications reported in the included RCTs but were reported heterogeneously with variability in reporting of the three key components of its definition including description and severity of the flow restriction, the need for intervention and etiology of flow restriction. In the future, defining PD access flow restriction should include all of these components to better evaluate the comparative effect of various PD access interventions.

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Section: Resultsmentioning

confidence: 99%

Peritoneal dialysis access outcomes reported in randomized controlled trials: A systematic review

et al. 2020

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“…Sanchez-Canel et al published a randomized study of 40 weighted versus 38 straight Tenckhoff catheters. Superior malposition-free survival rates and increased probability of malfunction in the Tenckhoff catheters (odds ratio 4.2) were seen, but this did not translate to a significant difference in survival (11). Early failure is most likely to be related to flow or catheter malposition compared with other complications.…”

Section: Discussionmentioning

confidence: 99%

“…Here it was shown, using a retrospective analysis, that complications were less frequent in the weighted group and dislocation of the catheters was 0.8% compared with 12.0% in Tenckhoff catheters. Two trials comparing open weighted versus open non-weighted and straight Tenckhoff catheters showed improved catheter survival in the weighted group (4) and less malpositions in the weighted group (10,11). Both studies did not consider factors that could influence catheter failure such as previous laparotomy and multiple previously failed catheters.…”

Section: Discussionmentioning

confidence: 99%

Outcomes of the Weighted Peritoneal Dialysis Catheter in Patients at Risk of Percutaneous Catheter Failure

et al. 2019

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Background The weighted catheter has shown promising results in retrospective and randomized studies. We examined its usefulness in patients with previous failed non-weighted peritoneal dialysis (PD) catheters or previous abdominal surgery. Methods The insertion, start, end, and removal dates were recorded for all-type catheter insertions from 2011 to 2016. Primary and secondary failure rates were recorded, defined as failure to ever establish flow (primary) or failure after a period of successful PD (secondary). Patients were censored from analysis if PD ended due to death, transfer of care, transfer to hemodialysis, transplantation, or if the patient recovered renal function. Results There were 44 weighted, 75 non-weighted open surgical, and 143 percutaneous catheters. There was previous abdominal surgery in 29% and 6% of patients receiving surgically inserted and percutaneous catheters, respectively ( p < 0.0001). Primary failure rates were 4/44 (9%), 20/75 (27%), and 26/143 (18%) in weighted, non-weighted surgical, and percutaneous catheters, respectively. There were reduced primary and secondary failure rates in the weighted (9% primary and 15% secondary) versus non-weighted surgically inserted group (27% primary and 46% secondary) ( p = 0.04). There was no difference between primary ( p = 0.15) and secondary ( p = 0.5) failure rates between weighted and percutaneously inserted catheters. Kaplan-Meier survival analysis revealed overall increased catheter survival in the weighted group ( p = 0.02). Conclusion Weighted catheters were associated with increased survival and decreased failure rates compared with non-weighted surgical catheters, despite usage in patients at higher risk of catheter failure due to previous failed catheters and abdominal surgery.

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“…Another recent prospective randomized study compared catheter dysfunction in 40 incident PD patients using a single-cuff self-locating catheter and 38 patients using a single-cuff, straight Tenckhoff catheter (26). The study confirmed the hypothesis that Tenckhoff catheters have more malfunctions and a lower malposition-free survival rate than self-locating catheters.…”

Section: The Self-locating Pd Cathetermentioning

confidence: 99%

“…The study confirmed the hypothesis that Tenckhoff catheters have more malfunctions and a lower malposition-free survival rate than self-locating catheters. In particular, multivariate logistic regression analysis indicated an increased probability of malfunction with the use of Tenckhoff catheters (OR = 4.5) (26).…”

Section: The Self-locating Pd Cathetermentioning

confidence: 99%

Type of Peritoneal Dialysis Catheter and Outcomes

et al. 2015

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In peritoneal dialysis (PD), a well-functioning catheter is of great importance, because a dysfunctional catheter may be associated with incidence of peritonitis, efficiency of dialysis, and to the overall quality of treatment, representing one of the main barriers to optimal use of PD. When considering the relationship between PD catheter type and outcomes, we should keep in mind the different types of available PD catheters, those that are most commonly used in clinical practice, and the available head-to-head comparisons in the literature. The main differences in PD catheter design include the number of cuffs, the shape of subcutaneous tract (straight vs. swan neck), and the shape of intraperitoneal tract (straight vs. coiled). The availability of the best catheter design and materials, along with a skillful management of PD access, may have the greatest impact on long-term patient outcome on PD. It is now established that the use of straight catheters may improve outcomes and technique survival, but further advances in PD catheter technology can potentially improve technique survival. The self-locating PD catheter is a well established device that has not been fully studied and it may represent, based on the available observational evidence and on the clinical experience, an already existing technological advance deserving further studies.

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Prospective Randomized Study Comparing a Single-Cuff Self-Locating Catheter with a Single-Cuff Straight Tenckhoff Catheter in Peritoneal Dialysis

Abstract: The study confirms the hypothesis that TCs have more malfunctions and a lower malposition-free survival rate than SLCs, and TCs are considered as the highest risk factor for malfunction during all study periods.

Cited by 13 publications

References 21 publications

Peritoneal dialysis access outcomes reported in randomized controlled trials: A systematic review

Peritoneal dialysis access outcomes reported in randomized controlled trials: A systematic review

Outcomes of the Weighted Peritoneal Dialysis Catheter in Patients at Risk of Percutaneous Catheter Failure

Type of Peritoneal Dialysis Catheter and Outcomes

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