Long-term experience with polyurethane, pail handle, coiled tip peritoneal dialysis catheters

Area of Science:

• Nephrology
• Biomaterials Science
• Surgical Devices

Background:

• Peritoneal dialysis (PD) is a crucial renal replacement therapy.
• Long-term PD catheter survival is essential for treatment efficacy.
• Optimizing catheter design and managing complications are key challenges.

Purpose of the Study:

• To assess the long-term performance and complications of polyurethane, pail handle, coiled tip PD catheters.
• To identify factors influencing catheter survival and removal.
• To evaluate the impact of catheter design on patient outcomes.

Main Methods:

• Retrospective analysis of 63 polyurethane PD catheters implanted in 57 renal failure patients.
• 100% follow-up over 1,248 patient-months.
• Analysis of catheter survival rates, complication incidence (infection, blockage, leaks), and reasons for removal.

Main Results:

• Cumulative catheter survival rates: 80.8% at 12 months, 62.3% at 24 months, 48.1% at 51 months; catheter half-life of 32.6 months.
• Most frequent complication: infection (peritonitis rate 0.73, exit site/tunnel infection rate 0.42 episodes/patient-year).
• Infection led to 28.6% of device removals; a specific adapter design was linked to increased exit site infections and catheter loss.

Conclusions:

• Polyurethane, pail handle, coiled tip PD catheters demonstrate reliable long-term performance.
• Infection remains the primary cause of catheter-related complications and removal.
• Catheter adapter design significantly impacts exit site health and device longevity, necessitating design improvements.