Comparative Analysis of Two-Piece Extended Peritoneal Dialysis Catheters with Remote Exit-Site Locations and Conventional Abdominal Catheters

Crabtree, John H.; Burchette, Raoul J.

doi:10.3747/pdi.2009.00004

Cited by 30 publications

(20 citation statements)

References 23 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In a prospective nonrandomized study, 2-piece extended catheters, which permit pre-sternal exit site away from problematic abdominal conditions, was compared to conventional catheters (62). The result showed that although extended catheters enabled peritoneal access for patients in whom conventional catheter placement would be difficult or impossible, they were associated with a higher risk of relapsing peritonitis episodes, especially those caused by coagulase-negative staphylococcal species (62).…”

Section: Catheter Designmentioning

confidence: 99%

ISPD Catheter-Related Infection Recommendations: 2017 Update

et al. 2017

View full text Add to dashboard Cite

Section: Catheter Designmentioning

confidence: 99%

ISPD Catheter-Related Infection Recommendations: 2017 Update

et al. 2017

View full text Add to dashboard Cite

“…9,12 Similarly, there was no significant association of the outcomes with weight or body mass index, although the available literature shows equivocal findings in this respect. [13][14][15] However, as can be judged from Tables 2 and 3, swan neck angle category was associated with body size, and inclination was related to body size and history of abdominal surgery. From this, it can be interpreted that proper positioning of a PD catheter in the abdominal wall is a greater challenge in obese patients and patients with a history of abdominal surgery.…”

Section: Discussionmentioning

confidence: 99%

Postimplantation X-ray parameters predict functional catheter problems in peritoneal dialysis

Bammens

Peeters

Jaekers³

et al. 2014

Kidney International

View full text Add to dashboard Cite

Functional catheter problems are a major challenge for peritoneal dialysis (PD) programs. Here we performed a retrospective single-center study of 110 consecutive patients receiving a first PD catheter (swan neck double-cuff Missouri curled catheters, open surgical technique). Using postimplantation X-ray, the following categories were defined: swan neck angle (posterioanterio view (PA): under 45°, 45-90°, over 90°), inclination (angle between intramural part of catheter and horizontal line; lateral view: greater than/equal to 30°, under 30°), and the position of silicone bead relative to spine (PA view: L1-2, L3-4, lower) and catheter tip (PA view: hypogastric, umbilical, subcostal). Covariates included demographics, body size, previous abdominal surgery, and abdominal wall hernias. During a mean follow-up of 36 months, the time to first functional catheter problem was significantly associated with both the swan neck angle and inclination. The need for surgical intervention was significantly associated with inclination only. Technique failure was not associated with any parameter. In multivariate analysis, inclination was the sole variable significantly associated with functional catheter problems (hazard ratio 3.65 [1.98-6.72]) and the need for surgical intervention (hazard ratio 2.86 [1.19-6.88]). Thus, our study defines a set of X-ray variables that predict functional PD catheter problems and can be used for troubleshooting in individual cases as well as for education and internal audit purposes.

show abstract

“…Understanding whether obesity directly increases the risk of PD-related infection is important because, if such is the case, then changing the location of the exit site to a presternal location might be of benefit (9)(10)(11). If, however, obesity is simply a marker of peritonitis risk, then the factors associated with obesity that are contributing to the development of CNS peritonitis should instead be targeted.…”

Section: Obesity and Pd-related Infectionmentioning

confidence: 99%

Frequency and Microbiology of Peritonitis and Exit-Site Infection among Obese Peritoneal Dialysis Patients

et al. 2013

View full text Add to dashboard Cite

♦ Background: Data on obesity as a risk factor for peritonitis and catheter infections among peritoneal dialysis (PD) patients are limited. Furthermore, little is known about the microbiology of PD-related infections among patients with a high body mass index (BMI). ♦ Methods: Using a cohort that included all adult patients residing in the province of Manitoba who received PD during the period 1997 -2007, we studied the relationship between BMI and PD-related infections. After categorizing patients into quartiles of BMI, a multivariate Cox regression model was used to determine the independent relationship between BMI and peritonitis or exit-site infection (ESI). We also studied whether increasing BMI was associated with a propensity to infections with particular organisms. ♦ Results: Among 990 PD patients, 938 (95%) had accurate BMI data available. Those 938 patients experienced 1338 peritonitis episodes and 1194 exit-site infections. In unadjusted analyses, patients in the highest BMI quartile (median: 33.5; interquartile range: 31.9 -36.4) had an increased risk of peritonitis overall, and also an increased risk of peritonitis with gram-positive organisms and coagulase-negative Staphylococcus (CNS). After multivariate adjustment for age, sex, diabetes, cause of renal disease, Aboriginal race, PD modality, and S. aureus nasal carriage, the relationship between overall peritonitis risk and BMI disappeared, but the increased risk of CNS peritonitis among patients in the highest BMI quartile persisted (hazard ratio: 1.80; 95% confidence interval: 1.06 to 3.06; p = 0.03). There was no increased risk of ESI among patients in the highest BMI quartile on univariate analysis or after multivariate adjustment. ♦ Conclusions: Among Canadian PD patients, obesity was not associated with an increased risk of peritonitis overall, but may be associated with a higher risk of CNS peritonitis.

show abstract

Comparative Analysis of Two-Piece Extended Peritoneal Dialysis Catheters with Remote Exit-Site Locations and Conventional Abdominal Catheters

Abstract: Extended catheters enable peritoneal access for patients in whom conventional catheter placement would be difficult or impossible. Certain patient and extended-catheter characteristics may contribute to loss from peritonitis.

Cited by 30 publications

References 23 publications

ISPD Catheter-Related Infection Recommendations: 2017 Update

ISPD Catheter-Related Infection Recommendations: 2017 Update

Postimplantation X-ray parameters predict functional catheter problems in peritoneal dialysis

Frequency and Microbiology of Peritonitis and Exit-Site Infection among Obese Peritoneal Dialysis Patients

Contact Info

Product

Resources

About