Peritoneal Catheter: Technique, Longevity, Complications

Abstract

Although the initial technique of performing continuous ambulatory peritoneal dialysis (CAPD) was developed in 1975 [1], it did not gain wide use and acceptance until 1978, when the technique was adapted to the use of dialysate solutions in plastic bags [2]. Children were first treated with ambulatory dialysis in 1978 [3], and since that time, many hospitals have developed large ambulatory peritoneal dialysis units. Continuous cycling peritoneal dialysis (CCPD) is an evolutionary offshoot of CAPD and intermittent peritoneal dialysis. CCPD offers the opportunity for home care with several additional advantages, including marked mobility during the daylight hours [4]. The development of the Tenckhoff silicone rubber catheter (Life Med, Inc., Compton, CA) has made it feasible to insert peritoneal dialysis catheters with the anticipation that they will function for prolonged periods, exceeding one year in most cases, while causing minimal irritation to the viscera and peritoneal surface [5, 6]. During the past few years, it has become increasingly apparent that ambulatory peritoneal dialysis has many advantages over hemodialysis in children with end stage renal disease including larger dietary intake of calories, lower blood pressure, decreased need for transfusion, increased mobility, and considerable decrease in cost [7].