Korean J Nephrol.  2006 Mar;25(2):205-211.

The Effect of Simultaneous Catheter Removal and Replacement for Recurrent Peritonitis and Catheter-related Infections in Peritoneal Dialysis Patients

• Lee KT
• Kwak JH
• Hwang EA
• Han SY
• Park SB
• Kim HC
• Koo JH
• Kim HT
• Cho WH

Abstract

BACKGOUND: Recurrent peritonitis and catheter-related infection, in which removal of the PD catheter and temporary hemodialysis are required, are the main cause of limited technical survival in peritoneal dialysis (PD). The aim of this study was to verify whether the simultaneous catheter removal and replacement (SRR) is feasible and safe in patients with recurrent peritonitis and catheter-related infection.
METHODS
From January 2001 to December 2004, We performed 47 SRR in 42 PD patients for the treatment of recurrent peritonitis and catheter-related infection to avoid the interruption of PD.
RESULTS
Indications for SRR were recurrent peritonitis in 16 (34.0%), catheter infection without peritonitis in 16 (34.0%), catheter infection with peritonitis in 11 (23.5%) and peritonitis with dialysate leakage in 4 (8.5%). SRR was successful in 89.4%. However, SRR was failed in 10.6% due to persistent tunnel infection in three, drainage failure and hernia in each one. PD was continued after SRR during 14.5+/-11.8 months and subsequent catheter longevity ranged from 3 to 47 months. The most common causative organism of recurrent peritonitis and catheter-related infection was MRSA (25.5%). Subsequent peritonitis occurred in 52.4% of patients with the mean of 10.5+/-9.6 months after SRR. However, 81.8% of subsequent peritonitis were due to new organisms. Postoperative complications occurred in 16 cases (34.0%) including five cases with dialysate leakage, four with persistent tunnel infection, four with early peritonitis, two with drainage failure and one with bleeding.
CONCLUSION
We conclude that SRR is a safe and effective procedure in patients with recurrent peritonitis and catheter-related infection without the interruption of PD.

Keyword

Catheter-related infection; Recurrent peritonitis; Simultaneous catheter removal and replacement

MeSH Terms

Catheter-Related Infections*
Catheters*
Drainage
Hemorrhage
Hernia
Humans
Longevity
Methicillin-Resistant Staphylococcus aureus
Peritoneal Dialysis*
Peritonitis*
Postoperative Complications
Renal Dialysis