[Peritoneal dialysis catheter-related complications]

Area of Science:

• Nephrology
• Pediatric Nephrology
• Medical Device Engineering

Background:

• The double-cuff swan neck catheter has decreased peritonitis rates in chronic peritoneal dialysis.
• Complication rates associated with double-cuff swan neck catheter insertion remain largely uncharacterized.

Purpose of the Study:

• To evaluate the frequency and types of complications associated with double-cuff swan neck catheter insertion in pediatric patients undergoing chronic peritoneal dialysis.
• To compare complication rates between double-cuff swan neck catheters and traditional single-cuff straight catheters.

Main Methods:

• A retrospective analysis compared 221 double-cuff swan neck catheters (126 patients, 1990-2001) with 102 single-cuff straight catheters (54 patients, 1982-1990).
• Complications evaluated included dislocation, leakage with inflow/outflow malfunction, and infection (exit-site, tunnel, or early peritonitis).

Main Results:

• Double-cuff swan neck catheters showed high rates of dislocation (17%), leakage (17%), and infection (16%).
• Catheter removal was necessary for 8% due to dislocation, 1% due to leakage, and 4% due to infection.
• Dislocation leading to removal was significantly higher in children ≥ 6 years old (12%) compared to younger children (< 6 years old, 1%).
• Single-cuff straight catheters had lower removal rates for dislocation (4%) and leakage (6%) but higher for infection (12%).

Conclusions:

• While double-cuff swan neck catheters are effective in reducing peritonitis, they are associated with a higher risk of dislocation, particularly in older pediatric patients.
• Single-cuff straight catheters were replaced more often due to leakage and infection.
• Careful insertion techniques are recommended for double-cuff swan neck catheters, especially in older children, to mitigate dislocation risks.