title: The efficacy of silver-ion implanted catheters in reducing peritoneal dialysis-related infections.
abstract: BACKGROUND
  Dialysis-related infections are the commonest cause of catheter loss and transfer to hemodialysis. Surface modifications of the catheter that reduce infections are of major importance.
  
  
  OBJECTIVE
  The efficacy of silver-ion treated catheters in reducing dialysis-related infections was tested.
  
  
  METHODS
  The study design was a prospective, randomized controlled trial. Patients were implanted with either a silver-treated study catheter or a control catheter. Prospective collection of data included infectious complications and catheter survival.
  
  
  RESULTS
  The subject groups were comprised of 67 silver-treated catheters and 72 control catheters. Demographic characteristics of the study and control groups were equal. Exit-site infection rates for the study group and control group (0.52 and 0.45 episodes/patient-year of dialysis respectively) were not different by Poisson regression analysis (p > 0.4). Peritonitis rates were identical for the two groups (0.37 episodes/patient-year) and were not different by Poisson analysis (p > 0.9). Antibiotic-free intervals between infections for the study and control groups were not significantly different for exit-site infections (p = 0.58), peritonitis (p = 0.44), or both infections combined (p = 0.47). Actuarial analyses showed no differences between the groups in the probability of remaining free of exit-site infection (p > 0.2) or peritonitis (p > 0.7). Similarly, catheter survival was not significantly different between the groups (p > 0.6).
  
  
  CONCLUSIONS
  Surface modification of catheters with ion beam implantation of silver produced no clinical effect with respect to reducing dialysis-related infections.
authors.affiliation: Department of Surgery, Southern California Permanente Medical Group, Kaiser Permanente Bellflower Medical Center, Bellflower, California 90706, USA. John.H.Crabtree@kp.org
authors.forename: John H
authors.initials: JH
authors.lastname: Crabtree
authors.forename: Raoul J
authors.initials: RJ
authors.lastname: Burchette
authors.forename: Rukhsana A
authors.initials: RA
authors.lastname: Siddiqi
authors.forename: Isan T
authors.initials: IT
authors.lastname: Huen
authors.forename: Linda L
authors.initials: LL
authors.lastname: Hadnott
authors.forename: Arnold
authors.initials: A
authors.lastname: Fishman
mesh_terms: D000328:Adult; D000368:Aged; D002408:Catheters, Indwelling / Q000382:microbiology; D020099:Coated Materials, Biocompatible / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007477:Ions / Q000627:therapeutic use; D008297:Male; D019216:Metals, Heavy / Q000627:therapeutic use*; D008875:Middle Aged; D010530:Peritoneal Dialysis / Q000009:adverse effects* / Q000295:instrumentation*; D011446:Prospective Studies; D016459:Prosthesis-Related Infections / Q000382:microbiology*; D012834:Silver / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D020099:Coated Materials, Biocompatible; D007477:Ions; D019216:Metals, Heavy; D012834:Silver