Peritoneal Dialysis Access and Exit-Site Care Including Surgical Aspects

Autor: Zbylut J. Twardowski, W.K. Nichols, P. Kathuria
Rok vydání: 2023
Předmět:
Zdroj: Nolph and Gokal's Textbook of Peritoneal Dialysis ISBN: 9783030620868
Nolph and Gokal’s Textbook of Peritoneal Dialysis ISBN: 9780387789392
DOI: 10.1007/978-3-030-62087-5_14
Popis: One of the most important components of the peritoneal dialysis system is a permanent and trouble-free access to the peritoneal cavity. The double-cuff Tenckhoff catheter, developed in 1968 for treatment of patients with intermittent peritoneal dialysis [1], is also widely used for continuous ambulatory peritoneal dialysis (CAPD); however, CAPD increases catheter-related complications due to higher intraabdominal pressure and numerous daily manipulations. These complications, such as catheter-tip migration, dialysate leaks, and exit site infections are frequently encountered and often related to improper insertion and postimplantation care. Catheter exit site and tunnel infections are frequent in CAPD patients, leading to morbidity, prolonged treatment, recurrent peritonitis and catheter failure. Recent improvement in peritonitis rates due to widespread use of the Y-set has shifted the focus of attention to peritoneal access [2–4]. According to the National CAPD Registry, the overall 3-year survival of the various peritoneal catheters was 13–36% in the 1981–87 period [5]. The results have markedly improved in recent years.
Databáze: OpenAIRE