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Sayer, M.* ; Thiel, C.* ; Schenk, M.* ; Königsrainer, A.* ; Heyne, N. ; Birkenfeld, A.L. ; Artunc, F. ; Thiel, K.*

Intraperitoneal extension of the peritoneal dialysis catheter-a new technique for catheter implantation in patients with obesity.

J. Nephrol. 35, 311–316 (2021)
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BACKGROUND: In patients with obesity and end-stage kidney disease, implantation of the peritoneal dialysis (PD) catheter may be complicated by increased abdominal circumference or skin folds. Relocation of the implantation site to the upper abdomen could solve this problem. However, this would require an extended catheter. METHODS: We developed an extended PD catheter based on a swan neck Missouri PD catheter with the help of two adaptors and a straight intraperitoneal extension segment. The extended catheter was assembled intraoperatively, and its length was adjusted individually to ensure correct positioning. After the operation, PD was commenced and handled as usual. RESULTS: In the period from 2011 to 2021, we implanted 31 extended PD catheters in 29 patients (38% men) with end-stage renal failure and obesity. Median age was 53 (range 28-77) years and body mass index was 35.5 (range 26.4-46.9) kg/m2. The postoperative course was unremarkable except for seroma formation in one patient and dialysate leakage in another. Continuous ambulatory peritoneal dialysis (CAPD) was initiated in 20 and APD in 9 patients. The achieved median Kt/V was 2.10 (range 1.50-3.10). During the follow-up period lasting up to 51 months, there was one case of intraperitoneal catheter disconnection due to an avoidable handling error. The peritonitis rate was 1:40 months. The 1- and 2-year catheter survival was 92% and 67%, respectively, and paralleled patient survival. CONCLUSIONS: When using a PD catheter with an intraperitoneal extension, PD catheter implantation can be relocated to the upper abdomen in patients with obesity, thus providing optimal position and easy surgical access.
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Publication type Article: Journal article
Document type Scientific Article
Corresponding Author
Keywords Extended Pd Catheter ; Implantation ; Obesity ; Peritoneal Dialysis Catheter ; Peritoneal Dialysis Catheter Extended Pd Catheter
ISSN (print) / ISBN 1120-3625
e-ISSN 1724-6059
Quellenangaben Volume: 35, Issue: , Pages: 311–316 Article Number: , Supplement: ,
Publisher Springer
Publishing Place Tiergartenstrasse 17, D-69121 Heidelberg, Germany
Non-patent literature Publications
Reviewing status Peer reviewed
Grants Projekt DEAL