IMMEDIATE INITIATION OF CAPD FOLLOWING PERCUTANEOUS CATHETER PLACEMENT WITHOUT BREAK-IN PROCEDURE

• Published in: Peritoneal dialysis international 2007-03, Vol.27 (2), p.179-183
• Main Authors: Jo, Young-Il, Shin, Sug Kyun, Lee, Jong-Ho, Song, Jong-Oh, Park, Jung-Hwan
• Format: Article
• Language: English
• Subjects: Adult; Aged; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Biological and medical sciences; Catheterization - adverse effects; Catheterization - methods; Catheters, Indwelling - adverse effects; Diseases of the urinary system; Emergency and intensive care: renal failure. Dialysis management; Equipment Failure; Female; Follow-Up Studies; Humans; Intensive care medicine; Kidney Diseases - therapy; Male; Medical sciences; Middle Aged; Peritoneal Dialysis, Continuous Ambulatory; Prospective Studies; Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects); Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the urinary system; Time Factors
• ISSN: 0896-8608; 1718-4304
• DOI: 10.1177/089686080702700215

1 Division of Nephrology, Department of Internal Medicine, Konkuk University School of Medicine, Seoul; 2 Renal Division, Yonsei University Medical Center, NHIC Ilsan Hospital, Koyang, Korea Correspondence to: S.K. Shin, Renal Division, Department of Internal Medicine, YUMC, NHIC Ilsan Hospital, 1232 Baeksug-dong, Ilsandong-gu, Koyang-shi, Kyunggi-do, 410-719 Korea. sskyun{at}hotmail.com Objective To evaluate the effect of a modified method of percutaneous catheter placement without a break-in procedure on the development of catheter-related complications in patients on continuous ambulatory peritoneal dialysis (CAPD). Design : A prospective, observational clinical study. Setting : Peritoneal dialysis (PD) units of two university-based hospitals. Patients and Methods : This study included 51 consecutive patients on CAPD. A straight double-cuffed Tenckhoff catheter with a straight intraperitoneal segment was used, and all catheters were inserted using a modified percutaneous placement method under local anesthesia. The catheter was introduced directly into the deep pelvis through an intramuscular tract, which had been created by tapered dilators. Peritoneal dialysis was initiated immediately after catheter insertion without a break-in procedure. Catheterrelated complications were surveyed during the 12 months after initiation of CAPD. Results : Within the first month, only 1 pericatheter leakage (1.9%) was detected. There were no cases of visceral perforation or severe hemorrhage during catheter insertions. Catheter malfunction due to catheter tip migration, exit-site infection, and peritonitis developed in only 1.9%, 3.9%, and 3.9% of patients, respectively. After 1 month following catheter insertion, no further incidences of pericatheter leakage occurred during the follow-up period. All catheters, except one that was reinserted due to tip migration, survived throughout the study period. Conclusion : The rates of pericatheter leakage and other catheter-related complications are relatively low in CAPD patients using our percutaneous catheter placement method without a break-in procedure. This procedure is comparatively simple and less invasive than other catheter placement methods, and allows for immediate start of PD after catheter insertion, without a break-in procedure. KEY WORDS: KEY WORDS:; Methods of catheter insertion; complications of peritoneal dialysis. Received 27 July 2006; accepted 19 October 2006.