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A NEW APPROACH FOR CATHETER PLACEMENT AND CARE IN CAPD

From the Nephrology Section ofthe University of Antioquia School of Medicine and the Renal Unit of the Hospital Universitario San Vicente de Paul, Medellin, Colombia, South America.

Between April 1981 and December 1984, 54 double-cuff straight Tenckhoff catheters were inserted in 50 patients. This paper describes our experience with a new approach for catheter placement and care. It is based on a) ambulatory insertion by nephrologists; b) no flushing, heparinization or cycling; c) "break-in" delayed for two weeks and performed with regular two-liter bags; dialysis and d) ambulatory training carried out over 7-10 days. The actuarial survival rates of the catheters were 98% at 12 months and 80% at 24 and 36 months. Catheter failure was seen in six patients, three were due to peritonitis, two to tunnel infection and one to outflow obstruction caused by peritoneal adhesions. We conclude that this approach is feasible, safe, cheap and affordable and probably will produce less complications than other methods.

KEY WORDS: Tenckhoff catheter; catheter break-in; Peritoneal catheter; catheter implantation technique.

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