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Strategies to Avoid and Treat Peritoneal Dialysis Catheter Complications

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Complications in Dialysis

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Abstract

Successful peritoneal dialysis (PD) requires a well-functioning PD catheter. Several PD catheter types are available, including the straight tip, coiled tip, swan-neck, pre-sternal, and embedded catheters. The most common non-infectious PD catheter complications are flow problems due to one of four causes: (1) constipation, (2) fibrin plugging or occlusion of the internal catheter lumen by fibrin, (3) catheter migration, and (4) omental wrapping. Evaluation of catheter flow problems begins with eliminating constipation. Diagnostic imaging tests can help diagnose subclinical constipation, catheter migration, and catheter outflow hole obstruction. When faced with a poorly draining or nonfunctional but properly placed PD catheter without constipation, several maneuvers can be performed in the clinic to evaluate and treat catheter obstruction due to fibrin. Catheters suspected of migration or obstruction that continue to have impaired function will require further intervention to restore flow, either via guidewire manipulation under fluoroscopy or, ultimately, laparoscopic exploration, which can quickly identify and allow treatment of obstructed or migrated catheters.

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Author information

Authors and Affiliations

  1. Division of Nephrology, Stanford University, Stanford, CA, USA

    Anjali Bhatt Saxena

  2. Santa Clara Valley Medical Center, San Jose, CA, USA

    Anjali Bhatt Saxena

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  1. Anjali Bhatt Saxena
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Editor information

Editors and Affiliations

  1. Section of Nephrology, Baylor College of Medicine, Houston, TX, USA

    Stephen Z. Fadem

  2. Escola Bahiana de Medicina e Saúde Pública, Salvador, Bahia, Brazil

    José A. Moura-Neto

  3. Salisbury, VT, USA

    Thomas A. Golper

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© 2023 The Author(s), under exclusive license to Springer Nature Switzerland AG

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Saxena, A.B. (2023). Strategies to Avoid and Treat Peritoneal Dialysis Catheter Complications. In: Fadem, S.Z., Moura-Neto, J.A., Golper, T.A. (eds) Complications in Dialysis. Springer, Cham. https://doi.org/10.1007/978-3-031-44557-6_9

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  • DOI: https://doi.org/10.1007/978-3-031-44557-6_9

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-031-44556-9

  • Online ISBN: 978-3-031-44557-6

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