Peritoneal Dialysis Access: Prospective Randomized Comparison of the Swan Neck and Tenckhoffcatheters

Objective To examine the impact of peritoneal catheter configuration on mechanical complications, catheter survival, probability of episodes of peritonitis, and probability of exit -site infections associated with the use of catheters for continuous ambulatory peritoneal dialysis (CAPD).Design Prospective randomized trial.Setting CAPD unit in one university hospital, serving a population of 1.2 million.Patients Forty consecutive patients requiring their first dialysis catheter for future CAPD were randomized to receive either a two-cuff permanently bent Swan neck catheter or a two-cuff straight Tenckhoff catheter. The skin exit was downward-directed in the Swan neck group and upward-directed in the Tenckhoff group.Results Dialysate leak, catheter migration, or tunnel infection did not occur in any of the patients. Three outer cuff extrusions needing cuff shaving occurred, all in the Tenckhoffgroup(p =0.1). No significant differences could be demonstrated in catheter survival at 2 years, probability of episodes of peritonitis, or probability of exit-site infections.Conclusion Catheter configuration did not influence the catheter-related mechanical or infectious complications, and equally good results were obtained with both catheter types studied.