SURVIVAL OF 138 SURGICALLY PLACED STRAIGHT DOUBLE-CUFF TENCKHOFF CATHETERS IN PATIENTS ON CONTINUOUS AMBULATORY PERITONEAL-DIALYSIS

Objective: To determine the natural history of a surgically placed Ten ckhoff catheter in patients on continuous ambulatory peritoneal dialys is (CAPD). Design: Prospective 7-year study analyzing catheter surviva l of all catheters using the Kaplan-Meier life table methodology. Sett ing: Teaching hospital, department of nephrology. Patients: One hundre d and fifteen unselected patients beginning CAPD. Interventions: Remov al of the catheter required for the following complications: exit-site or tunnel infections or relapsing peritonitis, outflow obstruction, p ericatheter leak, and development of hernias. Main Outcome Measures: P eriod between insertion and removal of the catheter. Results: The cumu lative survival of all catheters after 1, 2, and 3 years of CAPD was 8 7%, 69% and 65%. Catheter survival of the first versus the second cath eter after 1 year was significantly longer (p=0.03). The difference wa s not significant in relation to diabetes, age, and sex. Infectious co mplications caused 61% (n=19) of all 31 catheter failures, mainly due to tunnel infections caused by Staphylococcus aureus (n=12). ''Mechani cal'' complications accounted for 49% (n=12) of catheter failures. Eig ht of 12 mechanical complications were outflow failures. Seven patient s had to be transferred to hemodialysis. Conclusions: The straight Ten ckhoff catheter is a reliable peritoneal access device for CAPD in an unselected patient population.