title: Shorter break-in period is a viable option with tighter PD catheter securing during the insertion.
abstract: BACKGROUND
  Recent single-arm studies reported good catheter outcome despite shorter break-in periods after peritoneal dialysis (PD) catheter insertions. These results were attributed to tight catheter securing during the insertions.
  
  
  OBJECTIVE
  To compare catheter-related outcomes after different break-in periods in the tightly secured PD catheters.
  
  
  METHODS
  The study cohort comprised 48 patients, who underwent catheter insertions with the modified insertion technique. Based on the duration of break-in period, the patients were grouped into a shorter break-in period arm, with break-in period of 7 days or less and a standard break-in period arm, with break-in period of about 2 weeks. Mean patient follow up was 9.68 +/- 4.35 months, with a similar follow-up duration between the two break-in period arms (P = 0.94).
  
  
  RESULTS
  In the study cohort, the incidence of pericatheter leaks, pericatheter haemorrhage, catheter malfunction and peritonitis was 2/48 (4%), 1/48 (2%), 1/48 (2%) and 3/48 (6%), respectively. There was no other-site leak, bowel perforation, hernia formation or wound dehiscence. Of these complications, two pericatheter leaks, one catheter malfunction and three peritonitis episodes followed standard break-in periods, whereas, one pericatheter haemorrhage occurred in the shorter break-in period arm.
  
  
  CONCLUSIONS
  After a tight catheter securing during the insertions, overall pericatheter leak incidence remained low in the whole study cohort, and it did not worsen despite a shorter break-in period. Future studies with larger patient numbers are needed to validate the role of shorter break-in period in PD practice.
authors.affiliation: Department of Paediatrics, Division of Nephrology, University of Western Ontario, London, Ontario, Canada. ajay.sharma@lhsc.on.ca
authors.forename: Ajay P
authors.initials: AP
authors.lastname: Sharma
authors.forename: Anil
authors.initials: A
authors.lastname: Mandhani
authors.forename: Shaji P
authors.initials: SP
authors.lastname: Daniel
authors.forename: Guido
authors.initials: G
authors.lastname: Filler
mesh_terms: D055499:Catheter-Related Infections / Q000209:etiology; D002404:Catheterization / Q000009:adverse effects* / Q000295:instrumentation; D002408:Catheters, Indwelling / Q000009:adverse effects*; D004868:Equipment Failure; D005260:Female; D006470:Hemorrhage / Q000209:etiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D010530:Peritoneal Dialysis / Q000295:instrumentation / Q000379:methods*; D010538:Peritonitis / Q000209:etiology; D010865:Pilot Projects; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome