Catheter salvage using revision for a peritoneal dialysis catheter with intractable exit site and/or tunnel infections

Semin Dial. 2023 Jan;36(1):53-56. doi: 10.1111/sdi.13094. Epub 2022 May 4.

Abstract

Background: In case of intractable exit site and/or tunnel infections, peritoneal dialysis (PD) catheter removal and re-insertion are recommended. Previous studies have reported the possibility of catheter salvage before removal, but they were either case-series or had a small sample size.

Methods: We identified all incident patients with PD who underwent revision at a tertiary medical center. In intractable exit site and/or tunnel infections, we tried catheter revision using a method with cuff shaving, using an original catheter, and creating a new tunnel. Revision success was defined as complete remission over more than 1 month after revision. We evaluated the infection-free and catheter survival rates.

Results: In total, 52 patients with PD underwent revision. The median age at the time of revision in the patients undergoing PD was 51 (21) years. There were 43 (82.7%) cases of revision success. Infection-free survival rates at 6 and 12 months were 57.0% and 35.1%, respectively. Catheter survival rates at 12 and 36 months were 72.5% and 56.2%, respectively.

Conclusion: The present study demonstrated that catheter revision can be a useful bridging method for original catheter salvage before catheter removal in intractable exit site and/or tunnel infections.

MeSH terms

  • Catheter-Related Infections* / therapy
  • Catheterization / methods
  • Catheters, Indwelling
  • Device Removal
  • Humans
  • Middle Aged
  • Peritoneal Dialysis* / adverse effects
  • Peritonitis*
  • Renal Dialysis