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Peritoneal Catheters and Related Infections

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Abstract

Catheter related infectious complications (exit-site infections, tunnel infections, and peritonitis) remain the major reasons for technique failure during the three decades since, continuous ambulatory peritoneal dialysis (CAPD) treatment has been first established. Despite improvements in catheter’s survival rates, catheter related complications result in an increase in the cumulative patients’ morbidity and often leading to the catheter removal. The ideal catheter provides reliable and rapid dialysate flow rates without leaks or infections. Among several types, the double-cuff straight Tenckhoff catheter, developed in 1968, is still the most widely used, although its use is decreasing in favour of swanneck catheters. Although there are onlu few well-designed trials comparing catheters and catheters related infectious complications, controlling for all other important variables, no difference in these complications among the main types of catheters was seen. The single cuff catheters have been associated with a shorter survival rate and time to the first peritonitis episode than the double-cuff catheters. Also exit-site infections were found to be more frequent and significantly more resistant to treatment with single-cuff compared to double-cuff ones. Finally, better results have been reported with the latest developed presternal peritoneal dialysis catheter both regarding survival rates and exit-site infection and peritonitis rates. Recently a renewed interest in continuous flow peritoneal dialysis stimulated inventions of imaginative, double-lumen catheters since a suitable peritoneal access is a sine qua non condition for the development of this new technique of peritoneal dialysis.

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Authors and Affiliations

  1. Department of Nephrology, Medical School Democritus University of Thrace, Canada

    Elias Thodis, Ploumis Passadakis, Stelios Panagoutsos & Vassilis Vargemezis

  2. Department of surgery, Medical School Democritus University of Thrace, Canada, Alexandroupolis, Greece

    Nikolaos Lyrantzopooulos

  3. Peritoneal Dialysis Program, The Toronto Western Hospital, University Health Network and University of Toronto, Toronto, Ontario, Canada

    Dimitrios Oreopoulos

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  1. Elias Thodis
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  2. Ploumis Passadakis
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  3. Nikolaos Lyrantzopooulos
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  4. Stelios Panagoutsos
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  5. Vassilis Vargemezis
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  6. Dimitrios Oreopoulos
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Correspondence to Elias Thodis.

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Thodis, E., Passadakis, P., Lyrantzopooulos, N. et al. Peritoneal Catheters and Related Infections. Int Urol Nephrol 37, 379–393 (2005). https://doi.org/10.1007/s11255-004-1562-1

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