Korean Journal of Nephrology 1993;12(4):658-665.
계속적외래복막투석에서 도관 재삽입이 도관생존에 미치는 영향
성상문 , 백효종 , 천병도 , 임종우 , 김동희 , 조동규 , 김영욱
Abstract
Patients who have lost catheters due to catheter- related complications and transplantation generally are considered to be at high risk for complications of subse- quent replacement. This study analyzed the experience of 152 peritoneal dialysis catheters (61 straight Tenck- hoff, 51 swan neck and 40 curl bent neck catheters) retrospectively, and compared the outcomes in patients with and without a history of replacement with respect to catheter survival and catheter-related complication rate. Out of 130 CAPD patients, 23 had two or more per- itoneal dialysis catheters reinserted. In 22 instances, catheters were removed due to catheter-related compli- cation and peritonitis; dislodgment"', peritonits, exit site infection', obstruction", leakage", catheter tearing" and in 1 instance due to kidney transplantation. There was no significant difference between cases with and without replacement with respect to catheter- related complication: peritonitis (with replacement: 0 136 vs without replacement: 0, 16/patient-months), exit site infection (0, 019 vs 0 029), dislodgment (0. 019 vs 0 .025), leakage (0 .003 vs 0. 012), hernia (0 .003 vs 0. 006), tunnel infection (0. 005 vs 0. 002), obstruction (0 vs 0. 001) and catheter tearing (0 vs 0. 001). By life table analysis, cumulative survival rates of catheters with replacement were 96% and 64% at 12 and 24 months respectively, and those of cases without replacement 78% and 54% at 12 and 24 months respectively. There was significant difference of cumulative survival rate at 12 months. However, at 24 months, no difference could be detectable between two groups with respect to catheter survival. In conclusion, these results that replacement does not influence on catheter surival and catheter-related complications in CAPD patients.
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