Straight Versus Coiled Peritoneal Dialysis Catheters: A Randomized Controlled Trial.
Am J Kidney Dis
; 75(1): 39-44, 2020 01.
Article
en En
| MEDLINE
| ID: mdl-31445925
ABSTRACT
RATIONALE & OBJECTIVE:
Despite a recent meta-analysis favoring straight catheters, the clinical benefits of straight versus coiled peritoneal dialysis catheters remain uncertain. We conducted a randomized controlled study to compare the complication rates associated with these 2 types of double-cuffed peritoneal dialysis catheters. STUDYDESIGN:
Multicenter, open-label, randomized, controlled trial. SETTING &PARTICIPANTS:
308 adult continuous ambulatory peritoneal dialysis patients. INTERVENTION Participants were randomly assigned to receive either straight or coiled catheters.OUTCOMES:
The primary outcome was the incidence of catheter dysfunction requiring surgical intervention. Secondary outcomes included time to catheter dysfunction requiring intervention, catheter migration with dysfunction, infusion pain measured using a visual analogue scale, peritonitis, technique failure, and peritoneal catheter survival.RESULTS:
153 patients were randomly assigned to straight catheters; and 155, to coiled catheters. Among randomly assigned patients who underwent peritoneal dialysis, during a mean follow-up of 21 months, the primary outcome of catheter dysfunction or drainage failure occurred in 9 (5.8%) patients who received a coiled catheter and 1 (0.7%) patient who received a straight catheter. Straight catheters had 5.1% lower risk for catheter dysfunction (95% CI, 1.2%-9.1%; P=0.02). The HR of the primary outcome for coiled versus straight catheters was 8.69 (95% CI, 1.10-68.6; P=0.04). Patients who received a coiled catheter had similar risk for peritonitis but reported higher infusion pain scores than those who received straight catheters.LIMITATIONS:
Generalizability to other peritoneal dialysis centers with lower volumes and other races and nationalities.CONCLUSIONS:
Use of straight Tenckhoff catheters compared with coiled catheters reduced the rate of catheter dysfunction requiring surgical intervention.FUNDING:
Funded by the Chinese University of Hong Kong. TRIAL REGISTRATION Registered at ClinicalTrials.gov with study number NCT02479295.Palabras clave
Texto completo:
1
Banco de datos:
MEDLINE
Asunto principal:
Catéteres de Permanencia
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Diálisis Peritoneal Ambulatoria Continua
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Fallo Renal Crónico
Tipo de estudio:
Clinical_trials
Límite:
Aged
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Año:
2020
Tipo del documento:
Article