Salvage of problematic peritoneal dialysis catheters

Arif Asif, Florin Gadalean, Cristovao F. Vieira, Renee Hogan, Carlos Leon, Donna Merrill, Renee Ellis, Amarilys Amador, Osmany Broche, Barbara Bush, Gabriel Contreras, Phillip Pennell

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Peritoneal dialysis (PD) is a markedly underutilized modality for permanent renal replacement therapy in the United States owing to a low rate of patient referral and high rate of patient dropout or transfer to hemodialysis. One cause for patient loss from PD is problematic PD catheters that often are removed rather than being subjected to simple surgical salvage procedures. We report three patients with problematic catheters and our approach to their management. The first patient developed erosion of the skin overlying the portion of the catheter between the deep and superficial cuffs after 6 months of PD. The second patient developed extrusion of the superficial cuff after 4 years of PD. The third patient demonstrated a localized abscess at the incision site for catheter insertion after 3 years of PD. Other than a mild superficial exit site infection and localized abscess in the second and third patient, respectively, there were no associated infections of the catheter tunnel and cuff or of the peritoneal cavity as determined by either clinical examination, ultrasound evidence of fluid collection, or cultures and white blood cell counts. All three cases were managed successfully by interventional nephrology on an outpatient basis and under local anesthesia without either catheter removal or placement of a new PD catheter. It was possible to continue uninterrupted PD in the first and third patients, while the second patient had temporary hemodialysis to allow for complete healing of the surgical wound. We conclude that in selected cases simple interventions can salvage problematic PD catheters and maintain patients on PD.

Original languageEnglish
Pages (from-to)180-183
Number of pages4
JournalSeminars in Dialysis
Volume19
Issue number2
DOIs
StatePublished - Mar 1 2006

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Peritoneal Dialysis
Catheters
Abscess
Renal Dialysis
Catheter-Related Infections
Patient Transfer
Patient Dropouts
Renal Replacement Therapy
Nephrology
Peritoneal Cavity
Local Anesthesia
Leukocyte Count
Outpatients
Referral and Consultation
Skin

ASJC Scopus subject areas

  • Nephrology

Cite this

Asif, A., Gadalean, F., Vieira, C. F., Hogan, R., Leon, C., Merrill, D., ... Pennell, P. (2006). Salvage of problematic peritoneal dialysis catheters. Seminars in Dialysis, 19(2), 180-183. https://doi.org/10.1111/j.1525-139X.2006.00148.x

Salvage of problematic peritoneal dialysis catheters. / Asif, Arif; Gadalean, Florin; Vieira, Cristovao F.; Hogan, Renee; Leon, Carlos; Merrill, Donna; Ellis, Renee; Amador, Amarilys; Broche, Osmany; Bush, Barbara; Contreras, Gabriel; Pennell, Phillip.

In: Seminars in Dialysis, Vol. 19, No. 2, 01.03.2006, p. 180-183.

Research output: Contribution to journalArticle

Asif, A, Gadalean, F, Vieira, CF, Hogan, R, Leon, C, Merrill, D, Ellis, R, Amador, A, Broche, O, Bush, B, Contreras, G & Pennell, P 2006, 'Salvage of problematic peritoneal dialysis catheters', Seminars in Dialysis, vol. 19, no. 2, pp. 180-183. https://doi.org/10.1111/j.1525-139X.2006.00148.x
Asif A, Gadalean F, Vieira CF, Hogan R, Leon C, Merrill D et al. Salvage of problematic peritoneal dialysis catheters. Seminars in Dialysis. 2006 Mar 1;19(2):180-183. https://doi.org/10.1111/j.1525-139X.2006.00148.x
Asif, Arif ; Gadalean, Florin ; Vieira, Cristovao F. ; Hogan, Renee ; Leon, Carlos ; Merrill, Donna ; Ellis, Renee ; Amador, Amarilys ; Broche, Osmany ; Bush, Barbara ; Contreras, Gabriel ; Pennell, Phillip. / Salvage of problematic peritoneal dialysis catheters. In: Seminars in Dialysis. 2006 ; Vol. 19, No. 2. pp. 180-183.
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