Peritoneal Dialysis Catheter Insertion.
The success of peritoneal dialysis as renal-replacement therapy depends on a well-functioning peritoneal catheter. Knowledge of best practices in catheter insertion can minimize the risk of catheter complications that lead to peritoneal dialysis failure. The catheter placement procedure begins with preoperative assessment of the patient to determine the most appropriate catheter type, insertion site, and exit site location. Preoperative preparation of the patient is an instrumental step in facilitating the performance of the procedure, avoiding untoward events, and promoting the desired outcome. Catheter insertion methods include percutaneous needle-guidewire with or without image guidance, open surgical dissection, peritoneoscopic procedure, and surgical laparoscopy. The insertion technique used often depends on the geographic availability of material resources and local provider expertise in placing catheters. Independent of the catheter implantation approach, adherence to a number of universal details is required to ensure the best opportunity for creating a successful long-term peritoneal access. Finally, appropriate postoperative care and catheter break-in enables a smooth transition to dialysis therapy.
Division of Nephrology and Hypertension, Harbor-University of California Los Angeles Medical Center, Torrance, CA. Electronic address: johncrabtree@sbcglobal.net.
John H
JH
Crabtree
Division of Nephrology, Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong.
Kai-Ming
KM
Chow
D002404:Catheterization / Q000379:methods*; D002408:Catheters, Indwelling; D004724:Endoscopy; D006801:Humans; D007676:Kidney Failure, Chronic / Q000628:therapy*; D010535:Laparoscopy; D010530:Peritoneal Dialysis / Q000295:instrumentation / Q000379:methods*; D011183:Postoperative Complications; D025321:Surgery, Computer-Assisted; D013514:Surgical Procedures, Operative
Peritoneal catheter; Tenckhoff catheter; catheter complications; peritoneal access; peritoneal catheter placement; peritoneal dialysis