Syed Munib, Asif Malik.
Outcome of CAPD Tenckhoff catheter-a single center experience.
Rawal Med J Jan ;36(2):124-8.

Objective: To study outcomes, complications and survival of straight Tenckhoff catheter after implantation during continous ambulatory peritoneal dialysis (CAPD). Patients and Methods: A retrospective analysis of 22 end stage renal disease (ESRD) patients who opted for CAPD at DHQ Teaching Hospital, Dera Ismail Khan from October 2004 to October 2005 was performed. Straight Tenckhoff catheters were inserted by open surgical method. Catheter-related complications such as dialysate leakage, drainage failure, malposition, infectious complications, and catheter loss were observed over a one year period. Results: Mean age was 47.5 years (15 years to 80 years). Out of 22 patients, 16 were male and 6 were female. 16 patients took CAPD as their first modality of dialysis while 6 patients choose it as a second modality after being on hemodialysis for some months. The etiologies of ESRD were chronic glomerulonephritis 8 (36.36%), hypertension 6 (27.27%), diabetes mellitus 5 (22.72%), calculus disease 1 (4. 55%), idiopathic 1 (4.55%) and adult polycystic kidney disease in 1 (4.55 %) patient. After straight Tenckhoff catheter implantation, pericatheter dialysate leaks were noted only in one patient, which spontaneously stopped within 2 weeks. Five patients had Tunnel or exit-site infection, 3 had catheter malposition, outflow failure and abdominal discomfort and 3 episodes of peritonitis occurred. In two patients Tenckhoff catheter had to be removed due to peritonitis within 3 months of insertion. Three patients, age 70 years, died of cardiovascular events and one, age 75 years, died of carcinoma urinary bladder within 3 months of insertion. Four patients were switched to hemodialysis due to non-affordabilty of daily cost of CAPD. The duration of hospitalization from the day of catheter insertion to discharge was 10-14 days. The actual one-year catheter survival was 63.63%. Conclusions: The surgical insertion of Tenckhoff catheter for CAPD had got both early and late complications. Early complications are more common in elderly diabetics and those with infections. Good glycemic control, treatment and prophylaxis of infection prior insertion of catheter may minimize these complications. Proper training of patients and nursing staff can be helpful in preventing late complications. One-year Tenckhoff catheter survival and removal rate was 63.63% and 9% respectively.

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