Peritoneal Dialysis Catheter Insertion

Division of Renal Diseases and Hypertension AND Center for Clinical Research and Evidence-based Medicine, McGovern Medical School University of Texas, Houston, TX, USA

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Giovanni F.M. Strippoli MD, PhD, MPH, MM (Epi),

Giovanni F.M. Strippoli MD, PhD, MPH, MM (Epi)

Professor of Nephrology Adjunct Professor of Epidemiology

Department of Emergency and Organ Transplantation – University of Bari, Bari, Italy

School of Public Health, University of Sydney, Sydney, NSW, Australia

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First published: 18 November 2022

https://doi.org/10.1002/9781119105954.ch50

Summary

Peritoneal Dialysis (PD) catheter insertion has a major impact on the uptake of the therapy for two important reasons. Poorly responsive access pathways delay and therefore inhibit access to PD, and poor catheter function increases early technique failure. Mechanical causes of technique failure are a particular problem early in the course of PD, and poor catheter function can prevent patients from getting their chosen dialysis modality. Insertion technique had no evidence of impact on catheter removal, peritonitis, or exit site infection rates following PD catheter insertion. The peritoneoscope allows visualization of the peritoneal cavity, but does not permit manipulation of peritoneal cavity contents and cannot be classed as a variation of laparoscopy. The objective of access pathways is to provide safe and responsive PD access that works. It is important that regular local audit is conducted of PD catheter outcomes and complication rates.

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