Simultaneous removal and replacement of infected peritoneal dialysis catheters

American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation
N L Majkowski, S R Mendley

Abstract

Infection is an important complication of peritoneal dialysis that often limits technique survival. Recurrent episodes of peritonitis caused by the same organism may be the result of catheter infection, necessitating removal. We performed 34 single-step catheter replacement procedures in children and young adults for recurrent peritonitis or refractory exit site and tunnel infections. The success rate of the procedure was high (85%), with rare instances of intraoperative contamination. The presence of Staphylococcus aureus infection or exit site and tunnel infection were not risk factors for worse outcome. All patients continued on peritoneal dialysis through catheter change without requiring interval hemodialysis. Eighteen peritoneal dialysis catheters were replaced in a staged procedure with an interval off peritoneal dialysis. There was one early reinfection of the new catheter. Patients with Pseudomonas sp infections were more likely to be treated with a staged procedure; S aureus infections were equally likely to be managed by staged or simultaneous catheter removals. Simultaneous removal and replacement of infected peritoneal dialysis catheters is an effective management strategy when compared with two-step catheter repla...Continue Reading

Citations

Feb 5, 2009·Pediatric Nephrology : Journal of the International Pediatric Nephrology Association·Vimal ChadhaBradley A Warady
Mar 9, 2019·Peritoneal Dialysis International : Journal of the International Society for Peritoneal Dialysis·Catarina MengManuel Pestana
Mar 11, 2019·Peritoneal Dialysis International : Journal of the International Society for Peritoneal Dialysis·Caroline VironClémence Bechade
Dec 8, 2000·ASAIO Journal : a Peer-reviewed Journal of the American Society for Artificial Internal Organs·S Q Lew, K Kaveh
Jul 3, 2009·Pediatric Surgery International·Francesco MacchiniAlberto Edefonti
Aug 8, 2012·Peritoneal Dialysis International : Journal of the International Society for Peritoneal Dialysis·Bradley A WaradyFranz Schaefer
May 25, 2002·The International Journal of Artificial Organs·C G Voinescu, R Khanna
Sep 21, 2004·Pediatric Nephrology : Journal of the International Pediatric Nephrology Association·Atsunori YoshinoHideo Nakai
Oct 3, 2015·Peritoneal Dialysis International : Journal of the International Society for Peritoneal Dialysis·John H Crabtree, Rukhsana A Siddiqi
Nov 10, 2000·Advances in Renal Replacement Therapy·B Piraino
Jan 3, 2001·American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation·J M Duch, J Yee

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