The Effect of Catheter Placement Technique on Technical Survival in Patients Receiving Continuous Ambulatory Peritoneal Dialysis

OBJECTIVE: The effect of the catheter placement method on technical survival was evaluated in patients receiving peritoneal dialysis and followed in our Nephrology Department.

MATERIAL and METHODS: Catheter placement method and functions were assessed retrospectively from medical records of 313 patients. Peritoneal catheter placement was achieved by the percutaneous technique in 220 (70.3%) patients and by the surgical technique in 93 (29.7%) patients.

RESULTS: Technical survival rates were 89.1%, 84% and 74.1% in the first, third and fifth year, respectively. The technique complication incidence was higher in patients where the catheter were placed percutaneously (31.3%) than those who had undergone surgical catheter placement (19.5%) (p=0.27). Incidence of exit site infection was lower in patients who were catheterized by the percutaneous technique (20.1.%) than those catheterized by the surgical technique (47.3%) (p<0.001). Herniation incidence was lower in patients where the catheter was placed percutaneously (3.6%) than surgically (17.2%) (p=0.001). There was no relationship between catheter placement method and peritonitis, leakage or revision requirement.

CONCLUSION: Our results indicate that the catheter placement method could improve patient comfort and reduce cost by altering the frequency of technical complications and exit site infection. Catheter placement by the percutaneous route can be achieved safely and effectively by experienced nephrologists.