The choice of peritoneal dialysis catheter design: variants and clinical implications

The success of peritoneal dialysis depends on the presence of a safe and well-functioning peritoneal access. The ideal catheter should be easy to place, durable, comfortable, and practical to use, while limiting the aesthetic impact and minimizing associated infectious as well as mechanical complications. The first catheter that came closest to fulfilling these criteria was designed by Tenckhoff in the late 1960s. Over the following fifty years, a variety of catheters have been developed, aiming to improve efficiency while reducing associated side effects. However, none of these newer designs has demonstrated clear superiority over the Tenckhoff catheter, and up to 30% of peritoneal dialysis failures are still attributed to access-related complications. Nowadays, the wide range of available catheter models allows for a personalized choice of the device. A tailored approach, combined with optimal placement techniques, and the experience of the nephrology center, can maximize the benefits of specific catheter features to suit individual patient conditions. For clinicians involved in the placement and management of peritoneal access, understanding the principles behind the different catheter configurations is essential when applying a personalized approach to the choice of the device.