Analysis of factors predicting survival of a second peritoneal dialysis catheter

Many studies have examined the survival of the first peritoneal dialysis (PD) catheter. However, data are scarce about the factors that influence the function and survival time of a second PD catheter. The purpose of the present study was to calculate the survival time of the second PD catheter and to examine factors that predict removal of that catheter. We conducted a retrospective study of second PD catheters inserted at our institution over a 10-year period from May 1992 to April 2002. The endpoint consisted of removal of the second catheter. Voluntary change to hemodialysis, kidney transplantation, transfer to another center, and death with a functioning catheter were censored observations. Catheter survival was analyzed by the Kaplan-Meier method. During the study period, 106 patients (59 men, 47 women) received a second catheter. The mean age of the patients was 55 +/- 14.9 years. One third of the patients had diabetes. The reasons for removal of the first catheter and insertion of the second one were peritonitis (n = 50), catheter malfunction (n = 20), catheter leak (n = 11), exit site or tunnel infection (n = 21), and failed kidney transplantation with resumption of PD (n = 4). The median survival of the second catheter was 48 months (95% confidence interval: 38 months to 59 months). On univariate analysis, increasing patient age and peritonitis as cause for removal of the first catheter were associated with an increased risk of removal of the second catheter. However, on multivariate analysis, only increasing patient age was associated with a greater risk to survival of the second catheter.