title: Correction of CAPD catheter displacement using alpha-replacement method.
abstract: BACKGROUND
  Malposition of the tip of a continuous ambulatory peritoneal dialysis (CAPD) catheter may impede a dialysis, and an invasive method, such as open or laparoscopic surgery, is necessary to correct its position. The alpha-replacement method is a nonsurgical procedure; however, the reported clinical experience has been limited. We thus reviewed our 19 cases to clarify the efficacy of this method.
  
  
  METHODS
  The alpha-replacement method was used in 19 patients [mean age, 50 +/- 14 years old; male/female ratio, 13/6; duration of catheter insertion, 23.7 +/- 23.9 months; total, 29 times in 19 patients (once in 13 patients, twice in 3, three times in 2, four times in 1 patient)]. All patients received a swan-neck J-type catheter. The procedure was carried out by using a special guidewire within 1-2 weeks after dislocation of the tips.
  
  
  RESULTS
  The procedure was successfully performed 22 times in 14 patients (success rate, 78% in each performance). Required time was only 5-10 min in most successful cases. No evident complications were encountered in any case.
  
  
  CONCLUSIONS
  The alpha-replacement method for a displaced CAPD catheter proved to be effective and safe.
authors.affiliation: Division of Nephrology and Hypertension, Department of Internal Medicine, Jikei University Daisan Hospital, 4-11-1 Izumihonchou, Komae, Tokyo 201-8601, Japan. kawapon@jikei.ac.jp
authors.forename: Shinya
authors.initials: S
authors.lastname: Kawamoto
authors.forename: Hiroyasu
authors.initials: H
authors.lastname: Yamamoto
authors.forename: Masaaki
authors.initials: M
authors.lastname: Nakayama
authors.forename: Yoshindo
authors.initials: Y
authors.lastname: Kawaguchi
authors.forename: Tatsuo
authors.initials: T
authors.lastname: Hosoya
mesh_terms: D000328:Adult; D000368:Aged; D002408:Catheters, Indwelling / Q000009:adverse effects*; D005260:Female; D005548:Foreign-Body Migration / Q000000981:diagnostic imaging / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009398:Nephrology / Q000379:methods*; D010531:Peritoneal Dialysis, Continuous Ambulatory / Q000009:adverse effects* / Q000295:instrumentation*; D011859:Radiography; D012189:Retrospective Studies