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Peritoneal dialysis access and exit-site care including surgical aspects

  • Z. J. Twardowski
  • W. K. Nichols

Abstract

One of the most important components of the peritoneal dialysis system is a permanent and trouble-free access to the peritoneal cavity. The double-cuff Tenckhoff catheter, developed in 1968 for treatment of patients with intermittent peritoneal dialysis [1], is also widely used for continuous ambulatory peritoneal dialysis (CAPD); however, CAPD increases catheter-related complications due to higher intraabdominal pressure and numerous daily manipulations. These complications, such as catheter-tip migration, dialysate leaks, and exit site infections are frequently encountered and often related to improper insertion and postimplantation care. Catheter exit site and tunnel infections are frequent in CAPD patients, leading to morbidity, prolonged treatment, recurrent peritonitis and catheter failure. Recent improvement in peritonitis rates due to widespread use of the Y-set has shifted the focus of attention to peritoneal access [2–4]. According to the National CAPD Registry, the overall 3-year survival of the various peritoneal catheters was 13–36% in the 1981–87 period [5]. The results have markedly improved in recent years.

Keywords

Peritoneal Dialysis Continuous Ambulatory Peritoneal Dialysis Exit Site Peritoneal Dialysis Catheter Peritoneal Catheter 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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© Springer Science+Business Media Dordrecht 2000

Authors and Affiliations

  • Z. J. Twardowski
  • W. K. Nichols

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