How We Treat PD Catheter Thinning Around the Exit Site to Prevent Catheter Rupture

Peritoneal catheter thinning is a rare complication that often occurs in patients undergoing peritoneal dialysis, finally leading to catheter rupture. Once it occurs near the proximal portion of the exit site, catheter removal and simultaneous insertion of a new catheter are often required. Here, we report a case of PD catheter rupture due to catheter thinning 6 years ago, and catheter thinning of a new catheter reoccurred 6 years later. In this recurrence, we successfully addressed the issue through tunnel reconstruction without removing the catheter. After cutting the catheter proximally 1 cm away from the thinning site, we connected a new catheter to the original catheter using a bidirectional connector. A new tunnel was re-constructed on the same side with subsequent excellent catheter function. Tunnel reconstruction may be a simple and safe therapeutic alternative for PD patients with worn or ruptured PD catheters.