Catheter-related complications in children on chronic peritoneal dialysis

Catheter-related complications--including infection, dialysate leak, subcutaneous leak, outflowfailure, and malfunction--are the principal causes of peritoneal dialysis (PD) failure. In the present retrospective study, we evaluated the catheter-related complications that occurred in children at our facility who were started on chronic PD during the period from July 1997 to August 2004. During the study period, 72 catheters were placed in 53 patients (28 girls, 25 boys). The average follow-up period was 29.4 + 19.3 months. Catheter-related complications developed in 41 patients. The risk for subcutaneous dialysate leak was no more significant when PD catheters were used early (< or = 7 days post placement) than when use was delayed (>7 days). Similarly, no significant difference was observed in the infection rate between the early- and delayed-use groups. During the study, 87 episodes of peritonitis occurred in 39 patients (1 episode / 18 patient-months). The infection rate was significantly different (p < 0.05) in patients with a low serum albumin level. No significant difference was seen between the early--and delayed--use groups in dialysis duration or number of catheter changes. However, we did observe a significant difference (p < 0.05) in subcutaneous leaks with longer dialysis duration. No correlation was observed between early or delayed catheter use and infection, dialysate leak, hernia, or subcutaneous leak. In conclusion, we observed no significant differences in catheter-related complications between early- and delayed-use catheter groups. A low serum albumin level appears to be a risk factor for infection after PD catheter placement.