Association of exit site of peritoneal dialysis catheter and catheter tip migration in continuous ambulatory peritoneal dialysis patients
Objective: To identify correlations between locations of exit site and incidence of catheter tip migrations, in end stage renal disease (ESRD) patients who obtained continuous ambulatory peritoneal dialysis (CAPD).
Materials and methods: Between January 2007 and April 2015, ESRD patients who underwent CAPD in Rajavithi hospital were enrolled in retrospective study. The data for analysis included; patient demographic, abdominal surgery history, ambulatory status, position of catheter from postoperative radiography, complications of CAPD, which were classified as migrations, obstructions, peritonitis, pericatheteric leakages, drain pains, revision or removal surgery, mechanical data of dialysate infusions within 6 month after surgery, infection rates of tissue bed or surgical wound in kidney transplantation were collected and analyzed for risk factors of catheter related complications using univariate and multivariate analysis.
Results: There were 172 patients who underwent CAPD, 113 patients had exit site on the left side of abdomen and 59 patients had the right exit site. In right exit site group, 21 (35.6%) patients had catheter tip migration, while in left exit site group 38 (33.6%) patient had catheter tip migrations. No correlations between exit site locations and incidence of catheter tip migrations (p=0.797). But, left sided intrapelvic position of catheter is associated with lower risk catheter tip migrations (OR 0.36, 95% CI 0.16-0.78, p=0.008). Other catheter related problems were not different between the two groups. Thirty-three (19.2%) patients needed revision or removal surgery within 6 month
Conclusion: Incidence of revision or removal surgery was 19.2 %. However, there is no correlations between exit site of abdomen and catheter tip migrations. The study show that the Left intrapelvic catheteral placement has lower incidence of catheter tip migrations.
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