Simultaneous catheter replacement-removal during infectious complications in peritoneal dialysis.
The aim of this study was to verify whether the replacement of the peritoneal catheter in a single operation and during infectious complications of peritoneal dialysis is effective and safe. Sixty-eight infectious complications refractory to appropriate antibiotic therapy were treated by this technique: 26 tunnel infections, 22 peritonitis-complicating tunnel infections, 12 refractory peritonitis, and 8 recurrent peritonitis. Operations were successful in all cases of tunnel infection and recurring peritonitis, and in all cases but one of peritonitis-complicating tunnel infection. Ten failures occurred among the 12 catheters removed for refractory peritonitis. Microorganisms cultured in these 10 failures were: Fungi (3 cases), Mycobacterium (2 cases), Pseudomonas (2 cases), Acinetobacter (1 case), Acinetobacter+Pseudomonas (1 case), and Enterococcus (1 case). Complications were 3 one-way obstructions and 2 external dialysate leaks. This study supports the simultaneous catheter replacement-removal procedure during infectious complications of peritoneal dialysis (PD) with the exception of refractory peritonitis; this technique spares the patient the temporary vascular access, the shift to hemodialysis, and a second operation to insert a new catheter. There are few complications.
Cancarini
G C
GC
Chair of Nephrology, University of Brescia, Italy.
Manili
L
L
Brunori
G
G
Camerini
C
C
Zubani
R
R
Colombrita
D
D
Pezzola
D
D
Maiorca
R
R
D002408:Catheters, Indwelling / Q000009:adverse effects; D006801:Humans; D007239:Infections / Q000209:etiology / Q000628:therapy*; D010530:Peritoneal Dialysis / Q000009:adverse effects; D010538:Peritonitis / Q000209:etiology / Q000628:therapy; D012086:Reoperation