Type of Peritoneal Dialysis Catheter and Outcomes

Abstract

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.

Peritoneal catheter survival: The impact of unroofing

“…It is recognised that there are no differences in the outcomes when comparing different types of peritoneal catheters [28,29]. Shape memory of the peritoneal catheters has been implicated in the catheter migration process [30].…”

Current guidelines in peritoneal dialysis – Part I

“…The main differences in PD catheter type include the number of cuffs, the shape of subcutaneous tract (straight vs. swan neck), and the shape of intraperitoneal tract (straight vs. coiled) 7 . Most PD cath eters are made of soft silicon rubber.…”

Techniques for Peritoneal Dialysis Catheter Placement

“…Peritoneal dialysis catheters come in various shapes (straight, pigtail-curled, swan-neck), lengths and numbers of Dacron cuffs (Figure 1). The peritoneal dialysis catheter is composed of a flexible silicone tube with an open-end port and several side holes to provide optimal drainage and absorption of the dialysate [2,10].…”

“…In adults, a double-cuff catheter is typically used. With the double-cuff peritoneal dialysis catheter, the proximal cuff is positioned in the preperitoneal space and the distal cuff in the subcutaneous tissue [2,10]. The pubic symphysis Evolving Strategies in Peritoneal Dialysis has been recommended as a reliable marker for the ideal location of the catheter tip in the true pelvis [2] (Figure 2).…”

“…An ideal PD catheter should allow for optimal inflow and outflow and should be kink resistant; it should have no effect on physiology of abdominal tissues, should be resistant to infection with good surgical handling and should be affordable [10].…”