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First published on June 30, 2010
Peritoneal Dialysis International 2010, doi:10.3747/pdi.2009.00171
Perit Dial Int 0(2010): 200900171-
2010
© 2010 International Society for Peritoneal Dialysis
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Research

EARLY INITIATION OF CONTINUOUS AMBULATORY PERITONEAL DIALYSIS IN PATIENTSUNDERGOING SURGICAL IMPLANTATION OF TENCKHOFF CATHETERS

Ya-Fei Yang1, Huang-Joe Wang2, Chin-Chung Yeh3, Hsin-Hung Lin4 and Chiu-Ching Huang5

1Division of Nephrology, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan
2School of Medicine, China Medical University Hospital, Taichung, Taiwan
3Department of Urology, China Medical University Hospital, Taichung, Taiwan
4Division of Nephrology, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan
5Division of Nephrology, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan

C. Huang, Division of Nephrology, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan. graceaekimo{at}yahoo.com.tw

ABSTRACT

Background: Nephrologists commonly recommend continuous ambulatory peritoneal dialysis (CAPD) with breakin periods of at least 2 weeks. We investigated the safety and feasibility of shorter break-in periods following surgical implantation of Tenckhoff catheters.

Methods: We retrospectively examined 310 patients that underwent Tenckhoff catheter implantation for the first time. The early group comprised 226 patients that started CAPD ≤ 14 days after implantation; the late group comprised 84 patients that started CAPD > 14 days after implantation. Catheter-related complications within 6 months were analyzed.

Results: A total of 310 patients were enrolled. Time to CAPD initiation was shorter in the early group (2.0 ± 2.7 days) than in the late group (40.6 ± 42.8 days) (p < 0.001). The bridge hemodialysis rate was higher in the late group (57.1%) than in the early group (31.4%) (p < 0.001). Overall, 33 early-group (14.6%) and 11 late-group patients (13.1%) developed catheter-related complications within 6 months. The early-group complications were leakage (n = 5), diminished outflow volume (n = 7), migration (n = 7), pericatheter hernia (n = 1), hemoperitoneum (n = 1), pericatheter infection (n = 3), and peritonitis (n = 9). The late-group complications were leakage (n = 2), diminished outflow volume (n = 5), migration (n = 2), and peritonitis (n = 2). Actuarial freedom from catheter-related complications was similar in both groups (log rank, p = 0.76).

Conclusion: Early initiation of CAPD with surgically implanted Tenckhoff catheters is feasible and safe. Shorter break-in periods are not associated with more catheter-related complications. The data from our peritoneal dialysis population suggest that early initiation is not associated with an increased number of complications. This needs to be confirmed in a randomized trial.

KEY WORDS: break-in procedure; complications; CAPD; Tenckhoff catheter.

Received 18 August 2009; Revision received 3 June 2010. accepted 9 June 2010.






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