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SIX-YEAR EXPERIENCE WITH CAPD CATHETERS IN CHILDREN

From the Divisons of Nephrology and Urology, The Hospital for Sick Children, and the Departments of Paediatrics and Surgery, University of Toronto, Toronto.

Over a six-year period, 78 chronic peritoneal catheters were implanted in 55 patients; mean age at insertion was 9.6 years (range 0.2 to 19.1 years) and mean body weight was 28.3 kg (range 4.5 to 63 kg). Singlecuff catheters were used almost exclusively and were inserted in the midline under general anesthetic. Complications included leakage (26%) and one-way catheter obstruction (17%). Exit site and/or tunnel infections developed in 25% and hernias in 20% of 55 patients. Twenty-six catheters required replacement or removal. Actuarial catheter survival was 50% at two years. A retrospective analysis of exit-site infections suggested a significant benefit with "covered" as opposed to "uncovered" catheters (p < 0.01). Despite difficulties with catheter function only one patient was taken off CAPD because of a leak into the pleural cavity. Recent experience suggests that paramedian catheter placement and the use of catheters of an appropriate length for children will reduce the incidence of leakage and one-way obstruction.

KEY WORDS: CAPD; Catheters; Pediatrics.

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