The self-locating catheter: Clinical evaluation and comparison with the Tenckhoff catheter

Background: Peritoneal catheter displacement appears to be related to vario us causes including omental attachment, bower contractions, peritoneal adhe sions, and the catheter floating in the dialysis fluid. In order to prevent this complication,which can impair peritoneal dialysis efficacy, Di Paolo et al. designed a "self-locating catheter" (SLC) that is similar to the Ten ckhoff catheter (TC) and includes a small tungsten cylinder (weight 12 g) a t the distal end (Di Paolo N, et al. The self positioning catheter. Proceed ings of the VII Italian Congress on Peritoneal Dialysis. Milan: Wichtig Edi tore, 1993:539-42). The weight of the tip prevents the catheter from floati ng and migrating by gravitation toward the Douglas cavity. Objective: Starting in 1996, we implanted SLC in 15 continuous ambulatory p eritoneal dialysis patients. The aim of our study was to compare the ratio of migration and other catheter-related complications between patients with SLC (196 patient-months) and 13 patients with conventional straight TC (29 5 patient-months). Results: Peritonitis ratio, catheter complication rate, dialysate inflow an d outflow, and weekly creatinine clearance were similar in the two groups o f patients. The incidence of catheter displacement was significantly higher (p = 0.0349) in the TC group than in the SLC group (4 vs 0). Conclusion: In our experience, the SLC seems to be useful in preventing cat heter migration by continuous gravitation of its extremity toward the pelvi c cavity.