Peritoneal dialysis access

BACKGROUND: Peritoneal dialysis (PD) related infections continue to be a major cause of morbidity and mortality in patients on PD. In the last ten years, in order to reduce cuff and exit-site infections, in continuous ambulatory peritoneal dialysis (CAPD) patients, we have positioned the superficial cuff subcutaneously 4 cm instead of 2 cm internal to the exit-site. METHODS: We analysed the infective episodes occurred in 123 CAPD patients (88 men and 35 women, mean age 62...

Exit-site infections (ESIs) increase the risk of developing peritoneal dialysis (PD) peritonitis and PD technique failure. There are no clear guidelines on how to monitor exit site (ES) after ESI with Staphylococcus aureus or Pseudomonas . We report on a 1-year observational study of 23 patients who developed an ESI with one of these serious pathogens. After completing initial antibiotic treatment, swabs were taken every month for 3 months. Primary treatment cure occurred in 19/23 (83%). Colonization of ES after primary cure occurred in 8/19 (42%) patients...

Catheter erosion into the small bowel is an uncommonly reported complication of continuous ambulatory peritoneal dialysis (CAPD). This can result in peritonitis, sepsis, fistula formation, and mortality. We report a 29-year-old female with end-stage renal disease presenting with nausea, profuse diarrhea immediately after dialysate instillation, change in color and odor of the dialysis output, and pain at the site of her peritoneal dialysis (PD) catheter. After a thorough evaluation, catheter tip erosion into the patient's small bowel lumen was diagnosed...

BACKGROUND: No consensus currently exists regarding the optimal approach for peritoneal dialysis catheter placement. We aimed to compare the outcomes of percutaneous and surgical peritoneal dialysis catheter placement. METHODS: A systematic review of the literature was performed using the MEDLINE, Cochrane Library, and Scopus databases (end-of-search date: August 29th, 2020). We included studies comparing percutaneous (blind, under fluoroscopic/ultrasound guidance, and "half-perc") and surgical peritoneal dialysis catheter placement (open and laparoscopic) in terms of their infectious complications (peritonitis, tunnel/exit-site infections), mechanical complications (leakage, inflow/outflow obstruction, migration, hemorrhage, hernia, bowel perforation) and long-term outcomes (malfunction, removal, replacement, surgery required, and mortality)...

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No abstract text is available yet for this article.

No abstract text is available yet for this article.

AIM: Successful catheter implantation is highly essential for delivering effective peritoneal dialysis (PD). The aim of the present study was to describe a newly developed, minimally invasive percutaneous technique for providing safe, timely, and effective peritoneal catheter insertion and assess the long-term outcome. MATERIALS AND METHODS: 100 PD catheters were placed in 100 consecutive patients by a nephrologist using the modified percutaneous technique with a special trocar, from August 1, 2010 to December 31, 2011...

Peritoneal dialysis (PD) is one of the treatment options for patients with end-stage renal failure. To start PD treatment, a catheter must be placed for access to the abdominal cavity, and it can be placed using surgical, laparoscopic, or percutaneous methods. However, complications can develop during catheter placement.In the present case report, we describe a patient in whom treatment was pursued after an unusual complication rarely mentioned in the literature: a dialysis catheter accidentally inserted percutaneously into the bladder...

BACKGROUND: Patients on peritoneal dialysis treatment represent 15% of the global dialysis population. The major complication of peritoneal dialysis is catheter and peritoneal infection. Peritoneal dialysis patients who receive kidney transplants are at increased risk of infection because of immunosuppressive therapy. AIM: The purpose of this study is to show our ideal timing to remove peritoneal catheter after kidney transplant, which gives adequate security on renal function recovery and reduction of septic risk...

Urgent-start peritoneal dialysis (USPD) is increasingly seen as a viable alternative to hemodialysis through a central venous catheter for late-presenting end-stage renal disease patients. However, concerns remain about starting dialysis early following the surgical implantation of the peritoneal dialysis (PD) catheter; urgent PD is often thought to be a safe option only after minimally invasive percutaneous catheter insertions. Analysis of the cumulative data from published literature presented in this review appears to negate this general perception and shows that compared to the percutaneous catheter insertions, starting PD urgently following surgically placed catheter is not associated with more catheter leaks, dysfunctions, or other complications...

Historically, hernias were repaired before peritoneal dialysis (PD) catheter placement to obviate hernia complications, or after PD catheter placement once hernias became symptomatic or complicated. The aim of this study was to evaluate the outcomes and safety of combined hernia repair and PD catheter placement (HPD) compared with PD catheter placement alone. Within the NSQIP databases (2005-2014), 4406 patients who underwent PD catheter placement alone and 330 patients who underwent HPD were identified. Thirty-day outcomes were compared...

BACKGROUND: Peritoneal dialysis (PD) catheter obstruction often leads to surgical revision and may require transition to hemodialysis. The purpose of this study was to evaluate risk factors (including omentectomy) associated with early PD catheter obstruction (<6 months from insertion). METHODS: A retrospective review of all PD catheters inserted at a single high-volume referral center (2005-2018) was performed. 185 PD catheters were placed in 123 patients (45 female)...

Mechanical complications in peritoneal dialysis (PD), including intraluminal clogging of the PD catheter by fibrin, omentum, or blood clot, are major causes of outflow problems and, in rare cases, lead to technical failure. To visualize an intraluminal image of patients undergoing PD with ineffective ultrafiltration (UF), a SpyGlass fiber optic probe was inserted into the catheter, together with SpyBite biopsy forceps, should the removal of clogging materials be needed. Applying these transcatheter devices in 2 PD patients with unexplained UF failure led to the demonstration of omental plugging at the catheter tip in the first patient and demonstration of intraluminal blood clots in the second patient from whom clots were removal successfully...

Peritoneal dialysis (PD) is a generally accepted method for treatment of patients with the end-stage renal disease. A larger proportion of PD patients transfer to haemodialysis every year than the converse. Many of the underlying causes of transfer to haemodialysis are preventable. Infectious complications still remain the most common reason for transfer of PD patients to haemodialysis, catheter-related problems are the second most common cause. For PD to be effective it is very important to provide a quality peritoneal access with the insertion of PD catheter with minimum complications...

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OBJECTIVE: To determine the best operation technique, open versus laparoscopic, for insertion of a peritoneal dialysis (PD) catheter with regard to clinical success. Clinical success was defined as an adequate function of the catheter 2 - 4 weeks after insertion. METHODS: All patients with end-stage renal disease who were suitable for PD and gave informed consent were randomized for either open surgery or laparoscopic surgery. A previous laparotomy was not considered an exclusion criterion...

BACKGROUND: Prophylactic laparoscopic omentopexy is a safe technique to prevent peritoneal dialysis (PD) catheter obstruction. For the first time, we would like to describe a surgical technique in which the omentopexy is done using a single PD port which is used for the omentopexy, PD catheter insertion, and the rectus sheath tunneling of the catheter. METHODS: The surgical method of the omentopexy using the PD port (US Patent 20170119430) will be thoroughly described...

BACKGROUND: The Standardizing Care to Improve Outcomes in Pediatric End Stage Renal Disease (SCOPE) Collaborative is a quality improvement initiative to reduce dialysis-associated infections. The frequency of peritoneal dialysis (PD) catheter exit site infection (ESI) and variables influencing its development and end result are unclear. We sought to determine ESI rates, to elucidate the epidemiology, risk factors, and outcomes for ESI, and to assess for association between provider compliance with care bundles and ESI risk...

Background: Malfunction of continuous ambulatory peritoneal dialysis (CAPD) catheters is a frequent complication and has traditionally been treated with a laparotomy. We present our experience with minimally invasive surgical (laparoscopic and thoracoscopic) salvage of CAPD catheters. Materials and Methods: Between October 2003 and June 2013, 19 patients (13 males and 6 females with a mean age of 37 years [range 28-64]) underwent minimally invasive laparoscopic salvage of malfunctioning CAPD catheters...