Peritoneal dialysis access: prospective randomized comparison of single-cuff and double-cuff straight Tenckhoff catheters.

BACKGROUND: A prerequisite to the technical success of chronic peritoneal dialysis is a functioning peritoneal catheter. The option of using Tenckhoff catheters with single or double Dacron cuffs has been available for almost 3 decades, but still there is no consensus as to which is the preferable type.

METHOD: Sixty consecutive patients requiring a catheter for CAPD were randomized to receive either a straight deep single-cuff Tenckhoff catheter or a double-cuff Tenckhoff catheter. The catheters were surgically inserted.

RESULTS: There were no early failures. Two subcutaneous cuff extrusions were treated with shaving of the cuff. In the long term, eight patients in both groups required transfer to haemodialysis (5 and 3 prolonged peritonitis, 1 and 0 exit-site infection, 2 and 5 unable to cope or inadequacy of dialysis). There was no significant difference in the probability of developing first episode of peritonitis or exit site infection between the groups. Overall probability of catheter survival was 95.5 and 96.7% at 1 year, 82.7 and 79.9% at 2 in the two groups respectively.

CONCLUSIONS: There was no significant difference between catheters with single or double cuffs with respect to catheter survival, episodes of peritonitis and exit-site infections.