Comparison of the Rate of Catheter Malposition and Survival according to the Site of Catheter Tip Placement

Joung, Young Hee; Lee, Tae Won; Kim, Hi Jin; Ihm, Chun Gyu; Kim, Myung Jae

Abstract

BACKGROUND: The peritoneal catheter of the continuous ambulatory peritoneal dialysis(CAPD) is patients' lifeline. A significant number of complications and catheter failures in CAPD are due to mechanical problems. We describe our retrospective experience with CAPD focusing on the rate of catheter displacement and survival according to the site of catheter tip placement in 70 cases of CAPD in Kyunghee University Hospital between November 1994 and February 2000.
METHODS
We describe our retrospective experience with CAPD focusing on the rate of catheter displacement and survival according to the site of catheter tip placement in 70 cases of CAPD in Kyunghee University Hospital between November 1994 and February 2000.
RESULTS
Among 70 cases of CAPD, 46 cases were right pelvic cavity tip placement and 24 cases were left. Causes of chronic renal failure(CRF) were diabetes mellitus in 29 cases(63%), hypertension in 13 cases (28%), glomerulonephritis in 4 cases(9%) in right pelvic cavity catheter tip placement and diabetes mellitus in 13(54%), hypertension in 10(42%), renal tuberculosis in 1 case(4%) left pelvic cavity catheter tip. There were no difference in causative diseases of CRF between both groups. Incidence of CAPD catheter tip displacement were 17.4%(8/46) at right and 4.2%(1/24) at left catheter(p=0.01). Methods for treatment of displacement were fluoroscopic brushing, laparoscopic manipulation and operation. Of the 9 cases, 5 case were received fluoroscopic brushing, 3 case were laparoscopic manipulation and 1 case was received operation. Other complication were peritonitis, catheter obstruction, hernia, death. Overall survival of catheter were 65%(30/46) at right and 71 %(17/24) at left catheter(p=NS).
CONCLUSION
The incidence of CAPD catheter tip displacement was higher with catheter tip at the right pelvis than left(p=0.01). But there is no difference in the catheter survival.