Outcome of peritoneal dialysis: Tenckhoff catheter survival in a prospective study

Loss of the peritoneal dialysis (PD) catheter is a major cause of PD technique failure and transfer to hemodialysis. In the present study, we report our experience with permanent peritoneal catheters. We prospectively analyzed 125 double-cuff coiled, swan-neck catheters implanted by the open surgical method in 120 patients from January 1996 to June 2003. The patients were evaluated monthly and followed for a total of 2806 patient-months. The mean age of the patients was 55 +/- 17 years (range: 22 - 91 years); 52% were men; 20% had diabetes; 10% were receiving immunosuppressive treatment; 45% were Staphylococcus aureus nasal carriers; and 93.3% were on automated PD. Catheter survival was 97% at 2 years and 92.2% at 5 years. A total of 59 early and late catheter complications were observed in 36 patients. These included exit-site infection at a rate of 0.125 episodes/ patient-year. The most frequent noninfectious complications were herniation (8%), leakage (6%), and bloody dialysate (3%). Statistical analysis did not identify variables that predicted the development of exit-site infection. The overall peritonitis rate was 0.149 episodes/patient-year. Our data suggest that the main catheter complication is infection. The low incidence of infection in our study is probably related more to good installation technique and aftercare than to the clinical characteristics of the patients.