Chronic peritoneal dialysis catheters: overview of design, placement, and removal procedures

The success of chronic peritoneal dialysis (PD) depends to a large extent on the success of the chronic PD access device. For the nephrologist placing and removing PD catheters, or for the nephrologist advising surgeons in this role, this article provides a review of designs of PD catheters and differences in function and complications, methods of insertion of PD catheters and relation to catheter outcomes, techniques for "burying" the external portion of the PD catheter and benefits of this technique, and techniques for removing PD catheters. As nephrologists become more closely involved in the creation, monitoring, and maintenance of access devices for end-stage renal disease (ESRD) patients, the successful function of these devices will increase. Nephrologists should make the critical decisions regarding the choice of access devices and methods for placement as they do for the choice to remove such access devices.