title: Rational choice of peritoneal dialysis catheter.
abstract: The peritoneal catheter should be a permanent and safe access to the peritoneal cavity. Catheter-related problems are often the cause of permanent transfer to hemodialysis (HD) in up to 20% of peritoneal dialysis (PD) patients; in some cases, these problems require a temporary period on HD. Advances in connectology have reduced the incidence of peritonitis, and so catheter-related complications during PD have become a major concern. In the last few years, novel techniques have emerged in the field of PD: new dialysis solutions, better connectology, and cyclers for automated PD. However, extracorporeal dialysis has continued to improve in terms of methods and patient survival, but PD has failed to do so. The main reason is that peritoneal access has remained problematical. The peritoneal catheter is the major obstacle to wide-spread use of PD. Overcoming catheter-related problems means giving a real chance to development of the peritoneal technique. Catheters should be as efficient, safe, and acceptable as possible. Since its introduction in the mid-1960s, the Tenckhoff catheter has not become obsolete: dozens of new models have been proposed, but none has significantly reduced the pre-dominance of the first catheter. No convincing prospective data demonstrate the superiority of any peritoneal catheter, and so it seems that factors other than choice of catheter are what affect survival and complication rates. Efforts to improve peritoneal catheter survival and complication rates should probably focus on factors other than the choice of catheter. The present article provides an overview of the characteristics of the best-known peritoneal catheters.
authors.affiliation: Department of Nephrology, Dialysis, and Transplantation, St. Bortolo Hospital, Vicenza, Italy. roberto.dellaquila@ulssvicenza.it
authors.forename: Roberto
authors.initials: R
authors.lastname: Dell'Aquila
authors.forename: Stefano
authors.initials: S
authors.lastname: Chiaramonte
authors.forename: Maria Pia
authors.initials: MP
authors.lastname: Rodighiero
authors.forename: Emilia
authors.initials: E
authors.lastname: Spanó
authors.forename: Pierluigi
authors.initials: P
authors.lastname: Di Loreto
authors.forename: Catalina Ocampo
authors.initials: CO
authors.lastname: Kohn
authors.forename: Dinna
authors.initials: D
authors.lastname: Cruz
authors.forename: Natalia
authors.initials: N
authors.lastname: Polanco
authors.forename: Dingwei
authors.initials: D
authors.lastname: Kuang
authors.forename: Valentina
authors.initials: V
authors.lastname: Corradi
authors.forename: Massimo
authors.initials: M
authors.lastname: De Cal
authors.forename: Claudio
authors.initials: C
authors.lastname: Ronco
mesh_terms: D002408:Catheters, Indwelling / Q000009:adverse effects; D004867:Equipment Design; D004868:Equipment Failure; D006801:Humans; D007239:Infections / Q000209:etiology; D007676:Kidney Failure, Chronic / Q000628:therapy; D017060:Patient Satisfaction; D010530:Peritoneal Dialysis / Q000295:instrumentation*; D011788:Quality of Life