International Urology and Nephrology

, Volume 51, Issue 6, pp 1053–1058 | Cite as

Peritoneal dialysis catheter insertion using a very-low-site approach: a 5-year experience

  • Li-Feng GongEmail author
  • Jing-Kui Lu
  • Wei-Gang Tang
  • Wei Xu
  • Ming Xu
  • Gui-Xiang Ma
Nephrology - Original Paper



Peritoneal dialysis (PD) catheter tip migration accounts for the majority of cases of PD catheter malfunction. In this case series, we described our experiences of using a modified PD catheter implantation approach through a site that is lower than the site that is conventionally used, to reduce catheter malfunction.


We retrospectively identified 76 patients who received PD catheter implantation at the Affiliated Wujin Hospital of Jiangsu University, among whom 39 received the traditional approach of low-site insertion and 37 received a modified approach of very-low-site insertion. All participants were followed up for at least 2 years after PD catheter implantation, and the development of catheter dysfunction or death during this period was monitored.


We found that the survival rate of the initially inserted catheter was 75.68% among the very-low-site group. This survival rate was significantly better than that observed among the low-site group (48.72%; p = 0.029). Kaplan–Meier curves of the initial catheter survival also showed that the catheter survival was significantly higher in the patients in the very-low-site group than those in the low-site group (log rank p = 0.012). Complications, such as catheter tip migration, were not observed in the very-low-site group, while tip migration occurred in 15.38% of the patients in the low-site group (very-low-site group vs low-site group: p = 0.039).


A safe and simple PD catheter implantation can be performed either through the low-site approach or the very-low-site approach.


Peritoneal dialysis Peritoneal dialysis catheter Catheter dysfunction 



This study was supported by Jiangsu University Medical Clinical Science and Technology Development Fund of China (JLY20160035) and Changzhou Wujin Science and Technology Bureau Fund of China (WS201610).

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

This study was approved by the ethics committee of the Affiliated Wujin Hospital of Jiangsu University. All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Informed consent

Written informed consent was obtained from all individual participants included in the study.


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Copyright information

© Springer Nature B.V. 2019

Authors and Affiliations

  • Li-Feng Gong
    • 1
    Email author
  • Jing-Kui Lu
    • 1
  • Wei-Gang Tang
    • 1
  • Wei Xu
    • 1
  • Ming Xu
    • 1
  • Gui-Xiang Ma
    • 1
  1. 1.Department of NephrologyAffiliated Wujin Hospital of Jiangsu UniversityChangzhouChina

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