title: Bleeding complications associated with peritoneal dialysis catheter insertion.
abstract: OBJECTIVE
  To identify the incidence of bleeding complications associated with peritoneal dialysis catheter insertion.
  
  
  METHODS
  Retrospective review at a tertiary-care center of all double-cuffed Tenckhoff catheters placed surgically from 1 January 1992 to 1 October 2003 to identify the incidence of major bleeding complications occurring with catheter insertion. Major bleeding episodes were defined as > or = 3% decline in hematocrit, or the need for surgical intervention or blood transfusion within 2 weeks of insertion.
  
  
  RESULTS
  292 catheters had been inserted in 263 patients. Six patients satisfied the criteria for a major bleeding event, for a major bleeding complication rate of 2%. Bleeding was associated with perioperative anticoagulation in 3 patients, uremia and thrombocytopenia in 1 patient, aspirin use and thrombocytopenia in 1 patient, and 1 patient experienced intraoperative bleeding. Coagulation parameters were not obtained prior to the procedure in 2 of the 6 patients.
  
  
  CONCLUSIONS
  The rate of serious bleeding complications related to catheter insertion is low and usually associated with anticoagulation. Holding anticoagulation therapy for a minimum of 24 hours during the postoperative period should eliminate much of the risk. Coagulation parameters should also be obtained and corrected preoperatively.
authors.affiliation: Renal-Electrolyte Division, Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA. mitals@upmc.edu
authors.forename: Sangeeta
authors.initials: S
authors.lastname: Mital
authors.forename: Linda F
authors.initials: LF
authors.lastname: Fried
authors.forename: Beth
authors.initials: B
authors.lastname: Piraino
mesh_terms: D002404:Catheterization / Q000009:adverse effects*; D006470:Hemorrhage / Q000453:epidemiology / Q000209:etiology*; D006801:Humans; D015994:Incidence; D010530:Peritoneal Dialysis / Q000009:adverse effects*; D012189:Retrospective Studies