title: Peritoneal catheter-related complications: a comparison between hemodialysis and intermittent peritoneal dialysis in the break-in period.
abstract: We prospectively monitored the clinical outcome of 89 curled, double-cuff peritoneal catheters (PC) implanted by surgeons over one year. Thirty-six cases (40%) were supported with hemodialysis (HD) (group A) and 53 cases (60%) were supported with weekly intermittent peritoneal dialysis (IPD) (small exchange volume with a cycler) (group B) for four weeks before commencing continuous ambulatory peritoneal dialysis (CAPD). PC-related complications between the two groups were compared. Ten cases failed to complete the six-month observation period (8 died, 1 received kidney transplant, and 1 defaulted follow-up),Total experience accumulated was 494 patient-months (195 patient-months in group A, 299 patient-months in group B). The incidence of pericatheter leakage (group A vs group B) was significantly higher in group B (0% vs 13%, p < 0.05). There were no significant differences in the incidence of other PC-related complications, removal of PC, and mortality rate in the two groups. The incidence of pericatheter leakage was significantly higher in diabetic patients (71% vs 22%, p < 0.05), and group B patients with leakage had a higher incidence of external cuff erosion 57% vs 7%, p < 0.005) and delay in CAPD training (71% vs 7%, p < 0.005). We conclude that both HD and IPD are equally safe renal replacement therapies in the break-in period, while patients supported with IPD had a higher incidence of pericatheter leakage, which was associated with other catheter-related morbidities including external cuff erosion and delay in CAPD training.
authors.affiliation: Department of Medicine, Queen Elizabeth Hospital, Hong Kong.
authors.forename: Y L
authors.initials: YL
authors.lastname: Cheng
authors.forename: K F
authors.initials: KF
authors.lastname: Chau
authors.forename: K S
authors.initials: KS
authors.lastname: Choi
authors.forename: F K
authors.initials: FK
authors.lastname: Wong
authors.forename: H M
authors.initials: HM
authors.lastname: Cheng
authors.forename: C S
authors.initials: CS
authors.lastname: Li
mesh_terms: D000328:Adult; D000368:Aged; D002408:Catheters, Indwelling; D003928:Diabetic Nephropathies / Q000628:therapy; D004867:Equipment Design; D004869:Equipment Safety; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007676:Kidney Failure, Chronic / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D010530:Peritoneal Dialysis / Q000295:instrumentation*; D011446:Prospective Studies; D011475:Prosthesis Failure; D006435:Renal Dialysis / Q000295:instrumentation*; D012307:Risk Factors