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Catheter configuration and outcome in patients on continuous ambulatory peritoneal dialysis: a prospective comparison
B H Eklund1, E O Honkanen, A R Kala
1Fourth Department of Surgery, Helsinki University Central Hospital, Finland.
Objective:
To examine the impact of peritoneal catheter configuration on mechanical complications, catheter survival, probability of episodes of peritonitis, and probability of exit-site infections associated with the use of catheters for continuous ambulatory peritoneal dialysis (CAPD).
Design:
Prospective randomized trial.
Setting:
CAPD unit in one university hospital.
Patients:
Forty consecutive patients requiring a dialysis catheter for future CAPD were randomized to receive either a single-cuff straight Tenckhoff catheter or a permanently bent single-cuff Swan neck catheter. The skin exit was upward-directed in the Tenckhoff group and downward-directed in the Swan neck group.
Results:
Dialysate leak occurred in one patient and symptomatic catheter tip migration in 3 patients with the Tenckhoff catheter but in none with the single-cuff Swan neck catheter (p = 0.5, p = 0.12). No significant differences in catheter survival at 2 years, probability of episodes of peritonitis, or probability of exit-site infections could be demonstrated.
Conclusion:
Catheter configuration did not influence the catheter-related mechanical or infectious complications. We were unable to demonstrate any advantage of the newer, permanently bent single-cuff Swan neck catheter over the conventional straight type.