A randomized controlled trial of coiled versus straight swan-neck tenckhoff catheters in peritoneal dialysis patients

Johnson, David W., Wong, Jennifer, Wiggins, Kathryn J., Kirwan, Robyn, Griffin, Anthony, Preston, John, Wall, Daryl, Campbell, Scott B., Isbel, Nicole M., Mudge, David W., Hawley, Carmel M. and Nicol, David L. (2006) A randomized controlled trial of coiled versus straight swan-neck tenckhoff catheters in peritoneal dialysis patients. American Journal of Kidney Diseases, 48 5: 812-821. doi:10.1053/j.ajkd.2006.08.010


Author Johnson, David W.
Wong, Jennifer
Wiggins, Kathryn J.
Kirwan, Robyn
Griffin, Anthony
Preston, John
Wall, Daryl
Campbell, Scott B.
Isbel, Nicole M.
Mudge, David W.
Hawley, Carmel M.
Nicol, David L.
Title A randomized controlled trial of coiled versus straight swan-neck tenckhoff catheters in peritoneal dialysis patients
Journal name American Journal of Kidney Diseases   Check publisher's open access policy
ISSN 0272-6386
1523-6838
Publication date 2006-11
Sub-type Article (original research)
DOI 10.1053/j.ajkd.2006.08.010
Volume 48
Issue 5
Start page 812
End page 821
Total pages 10
Editor B. L. Kasiske
Place of publication Maryland Heights, MO, United States
Publisher W B Saunders
Collection year 2006
Language eng
Subject 730118 Organs, diseases and abnormal conditions not elsewhere classified
110312 Nephrology and Urology
Formatted abstract Background:
Current clinical practice guidelines recommend that no particular type of peritoneal dialysis (PD) catheter has been proved superior to another. However, a recent Cochrane review recommended the need for a large, well-designed, randomized, controlled trial of straight versus coiled PD catheters because of the paucity and suboptimal quality of previously performed trials.

Methods:
A randomized controlled trial was undertaken at 2 metropolitan teaching hospitals comparing the effects of straight versus coiled PD catheters on time to catheter malposition (primary outcome), catheter-associated infection, technique failure, and all-cause mortality.

Results:
One hundred thirty-two PD patients were enrolled and randomly assigned to insertion of a coiled (n = 62) or straight catheter (n = 70). There was no significant difference in time to laparoscopic reposition between the 2 cohorts (log-rank score, 0.41; P = 0.52). However, median technique survival was significantly worse for coiled catheters (1.5 years; 95% confidence interval [CI], 1.2 to 1.8) compared with straight catheters (2.1 years; 95% CI, 1.8 to 2.5; P < 0.05), primarily because of increased risk for inadequate dialytic clearance with the former. On univariate Cox proportional hazards model analysis, insertion of a coiled PD catheter was associated significantly with a greater risk for technique failure (unadjusted hazard ratio, 1.86; 95% CI, 1.03 to 3.36). No difference was observed between the 2 groups with respect to catheter-associated infections or overall patient survival.

Conclusion:

Coiled catheters do not influence the risk for drainage failure caused by catheter malposition compared with straight catheters, but are associated with significantly increased risk for PD technique failure, primarily because of inadequate dialytic clearance.
Keyword Coiled Tenckhoff catheter
Exit-site infections
Kidney failure
Chronic
Peritonitis
Straight Tenckhoff catheter
Technique survival
Tunnel infections
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: 2007 Higher Education Research Data Collection
School of Medicine Publications
 
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Created: Wed, 15 Aug 2007, 10:01:00 EST