Long-term experience with polyurethane, pail handle, coiled tip peritoneal dialysis catheters.
Long-term experience with 63 polyurethane, pail handle, coiled tip peritoneal dialysis catheters surgically implanted in 57 consecutive patients with renal failure is presented. One hundred percent follow-up of the study group represented 1,248 patient-months of observation. Cumulative catheter survival rates were 80.8% at 12 months, 62.3% at 24 months, and 48.1% through 51 months. Catheter half-life was 32.6 months. Infection was the most frequent catheter related complication. Incidence rate of peritonitis was 0.73, and exit site/tunnel infection was 0.42 episodes per patient-year. Median time to first episode was 11.7 months for peritonitis, and 26.3 months for exit site/tunnel infection. Infection led to removal of 28.6% of implanted devices, mechanical blockage resulted in 6.4% loss, and pericatheter leak and tubing break each accounted for 1.6% of catheter removals. The polyurethane, pail handle, coiled tip peritoneal catheter was found to be a reliable long-term access device compared with reported performances of other catheter types. An adverse outcome was identified in the current clinical series with a model design using a permanently attached catheter adapter that caused large exit site wounds that were predisposed to infection and catheter loss.
Department of Surgery, Kaiser Permanente Bellflower Medical Center, California 90706, USA.
J H
JH
Crabtree
R A
RA
Siddiqi
J J
JJ
Chung
L T
LT
Greenwald
D000293:Adolescent; D000328:Adult; D000368:Aged; D001672:Biocompatible Materials; D002408:Catheters, Indwelling / Q000009:adverse effects*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010530:Peritoneal Dialysis / Q000295:instrumentation*; D010538:Peritonitis / Q000209:etiology* / Q000382:microbiology; D011140:Polyurethanes
D001672:Biocompatible Materials; D011140:Polyurethanes