Lower Malfunction Rate with Self-Locating Catheters

Abstract

We analyzed malfunction rates (obstruction, omental wrapping, displacement) and catheter survival for self-locating catheters as compared with other Tenckhoff catheter designs. We conducted our survey at two centers, prospectively studying all self-locating catheters implanted from May 1997 to October 2000 and used for peritoneal dialysis (PD). Tenckhoff catheters of other designs used previously in our units were used as the control group. We analyzed removal causes and catheter survival. We studied 173 catheters (105 self-locating catheters, 53 straight catheters, and 15 coiled catheters) implanted in 139 patients (43% of them women) with a mean age of 53 +/- 14 years. The analysis of catheter removal showed that 3 of 105 self-locating catheters, 3 of 15 coiled catheters, and 17 of 53 straight catheters were removed owing to malfunction (chi2: p = 0.0000). Kaplan-Meier curves showed that the bulk of removals for malfunction occurred within the first 3 months after PD start. The group of self-locating catheters showed better survival (log-rank: p = 0.0009). Other causes for catheter removal included peritonitis (n = 22), exit-site infection alone (n = 4), and end of PD treatment (n = 66). No significant differences were seen in the annual peritonitis rate (straight-tip: 0.955 +/- 2.315 episodes annually; coiled-tip: 0.651 +/- 0.864 episodes annually; self-locating: 0.720 +/- 1.417 episodes annually; t-test: p > 0.400). No gut or bladder perforations were observed. In our survey, self-locating catheters were associated with better survival and fewer removals for malfunction than were Tenckhoff catheters of other designs.