Comparison of Peritoneal Catheter Survival with Fistula Survival in Hemodialysis

Abstract

Objective To compare continuous ambulatory peritoneal dialysis (CAPD) and hemodialysis (HD) with regard to long-term maintenance of access. Design Retrospective study of a four to six-year time period at one center. Patients One hundred and twenty-two CAPD patients between December 1988 and December 1992, and 172 HD patients between May 1986 and December 1992. Main Outcome Measure Cumulative survival rate of peritoneal catheters and arteriovenous fistulas (AVF) was the main outcome measure. Variables affecting the survival rate including sex, age, presence or absence of diabetes, and type of AVF (autogenous or prosthetic graft) were assessed. The causes of peritoneal catheter failures were analyzed. Results The cumulative survival rate of all peritoneal catheters was significantly longer than the AVF survival rate (84% vs 74% at one year; 73% vs 61% at two years; and 63% vs 48% at three years) (p = 0.029). There were no differences in peritoneal catheter survival according to sex, age, or diabetes. Compared with A VF survival, peritoneal catheter survival was significantly longer in male (p = 0.0492), elderly (p = 0.0082), and diabetic (p = 0.0022) patients. Prosthetic graft and old age were risk factors for AVF survival. Of all peritoneal catheter failures, infectious complications were responsible for 75% (33/44) and mechanical complications for 25% (11/44). Peritonitis was the leading infectious complication (21/33) and outflow obstruction was the leading mechanical complication (9/11). Conclusion In terms of long-term maintenance of access, CAPD is superior to HD, especially in the elderly or diabetics. Prevention and proper management of peritonitis may prolong the peritoneal catheter survival.

Longitudinal comparison of dialysis access methods: Risk factors for failure

“…Our primary patency rate for PDCs of 58% at 1 year is similar to the 42% reported in the literature, 28,29 and at least one other large study has also indicated peritoneal dialysis has patency rates superior to those of hemoaccess. 12 We obtained these results despite the fact that 43% of our PDC patients had diabetes. Diabetes mellitus was the only identifiable risk factor for PDC failure, and failure was twice as likely in patients with diabetes.…”

The Self-Locating Catheter: Clinical Evaluation and Comparison with the Tenckhoff Catheter

“…Many types of catheters have been proposed that could reduce the tendency to migrate, such as TWH1 and TWH2 by Oreopoulos et al (2), the curled catheter (1), the Lifecath and the "T-fluted" catheter designed by Ash (3,4), the Valli catheter (5), the Swan-neck catheter by Twardowski (6), the Cruz catheter (7), and others. These models reduced the incidence of displacement, but nevertheless the frequency of displacement is still high (8).…”

Long-Term Outcomes of Single-Port Laparoscopic Placement of Peritoneal Dialysis Catheter

“…Recent studies have shown that PD is associated with increased survival compared to those treated with hemodialysis. [1][2][3][4] Successful PD therapy requires a functioning catheter placed in the abdominal cavity to allow unrestricted fluid exchange of the dialysate liquid from the peritoneal cavity.…”