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Perit Dial Int 23(4): 368-374 2003
© 2003 International Society for Peritoneal Dialysis
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Peritoneal Dialysis International, Vol 23, Issue 4, 368-374
Copyright © 2003 by International Society for Peritoneal Dialysis

Clinical Trial

The efficacy of silver-ion implanted catheters in reducing peritoneal dialysis-related infections

JH Crabtree, RJ Burchette, RA Siddiqi, IT Huen, LL Hadnott, and A Fishman

Department of Surgery, Southern California Permanente Medical Group, Kaiser Permanente Bellflower Medical Center, Bellflower, California 90706, USA. John.H.Crabtree@kp.org

BACKGROUND: Dialysis-related infections are the commonest cause of catheter loss and transfer to hemodialysis. Surface modifications of the catheter that reduce infections are of major importance. OBJECTIVE: The efficacy of silver-ion treated catheters in reducing dialysis-related infections was tested. METHODS: The study design was a prospective, randomized controlled trial. Patients were implanted with either a silver-treated study catheter or a control catheter. Prospective collection of data included infectious complications and catheter survival. RESULTS: The subject groups were comprised of 67 silver-treated catheters and 72 control catheters. Demographic characteristics of the study and control groups were equal. Exit-site infection rates for the study group and control group (0.52 and 0.45 episodes/patient-year of dialysis respectively) were not different by Poisson regression analysis (p > 0.4). Peritonitis rates were identical for the two groups (0.37 episodes/patient-year) and were not different by Poisson analysis (p > 0.9). Antibiotic-free intervals between infections for the study and control groups were not significantly different for exit-site infections (p = 0.58), peritonitis (p = 0.44), or both infections combined (p = 0.47). Actuarial analyses showed no differences between the groups in the probability of remaining free of exit-site infection (p > 0.2) or peritonitis (p > 0.7). Similarly, catheter survival was not significantly different between the groups (p > 0.6). CONCLUSION: Surface modification of catheters with ion beam implantation of silver produced no clinical effect with respect to reducing dialysis-related infections.




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