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Esagian SM, Spinos D, Vasilopoulou A, et al. Influence of peritoneal dialysis catheter type on complications and long-term outcomes: an updated systematic review and meta-analysis. J Nephrol. 2021;34(6):1973-1987doi: 10.1007/s40620-021-01016-y.
Esagian, S. M., Spinos, D., Vasilopoulou, A., Syrigos, N., Bishawi, M., Lehrich, R. W., Middleton, J. P., Suhocki, P. V., Pappas, T. N., & Economopoulos, K. P. (2021). Influence of peritoneal dialysis catheter type on complications and long-term outcomes: an updated systematic review and meta-analysis. Journal of nephrology, 34(6), 1973-1987. https://doi.org/10.1007/s40620-021-01016-y
Esagian, Stepan Michran, et al. "Influence of peritoneal dialysis catheter type on complications and long-term outcomes: an updated systematic review and meta-analysis." Journal of nephrology vol. 34,6 (2021): 1973-1987. doi: https://doi.org/10.1007/s40620-021-01016-y
Esagian SM, Spinos D, Vasilopoulou A, Syrigos N, Bishawi M, Lehrich RW, Middleton JP, Suhocki PV, Pappas TN, Economopoulos KP. Influence of peritoneal dialysis catheter type on complications and long-term outcomes: an updated systematic review and meta-analysis. J Nephrol. 2021 Dec;34(6):1973-1987. doi: 10.1007/s40620-021-01016-y. Epub 2021 Mar 22. PMID: 33751498.
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J Nephrol. 2021 Dec;34(6):1973-1987. doi: 10.1007/s40620-021-01016-y. Epub 2021 Mar 22.

Influence of peritoneal dialysis catheter type on complications and long-term outcomes: an updated systematic review and meta-analysis.

Journal of nephrology

Stepan Michran Esagian, Dimitrios Spinos, Anastasia Vasilopoulou, Nikolaos Syrigos, Muath Bishawi, Ruediger Wilhelm Lehrich, John Paul Middleton, Paul Vincent Suhocki, Theodore Nick Pappas, Konstantinos P Economopoulos

Affiliations

  1. Surgery Working Group, Society of Junior Doctors, Athens, Greece.
  2. Derby Royal Hospital, University Hospitals of Derby and Burton NHS Trust, Derby, UK.
  3. Department of General Surgery, Veterans Administration Hospital (NIMTS), Athens, Greece.
  4. Department of Medicine, School of Health Sciences, National and Kapodistrian University of Athens, Athens, Greece.
  5. Department of Surgery, Duke University Medical Center, 2301 Erwin Rd, Durham, NC, 27710, USA.
  6. Division of Nephrology, Department of Medicine, Duke University Medical Center, Durham, NC, USA.
  7. Department of Radiology, Duke University Medical Center, Durham, NC, USA.
  8. Surgery Working Group, Society of Junior Doctors, Athens, Greece. [email protected].
  9. Department of Surgery, Duke University Medical Center, 2301 Erwin Rd, Durham, NC, 27710, USA. [email protected].

PMID: 33751498 DOI: 10.1007/s40620-021-01016-y

Abstract

BACKGROUND: There is currently no consensus regarding the optimal type of peritoneal dialysis catheter (PDC). We compared the outcomes of PDCs according to the number of cuffs, intercuff and intraperitoneal segment shape, and presence of a weighted tip.

METHODS: A systematic review of the literature was performed using the MEDLINE and Cochrane Library databases (end-of-search date: October 16th, 2019). We included studies comparing double-cuff vs. single-cuff, swan-neck vs. straight-neck, coiled-tip vs. straight-tip, and weighted vs. non-weighted PDCs for the outcomes of interest. We performed meta-analyses using the random-effects model. We assessed the risk of bias using the Newcastle-Ottawa scale and the Cochrane Collaboration's Tool.

RESULTS: In total, 38 studies were identified, of which 20 were randomized controlled trials (RCTs) and 18 were observational studies. No statistically significant differences were detected between double-cuff vs. single-cuff, swan-neck vs. straight-neck, and coiled-tip vs. straight tip PDCs in any of the outcomes of interest. Weighted catheters were associated with significantly lower rates of tunnel infection (relative risk [RR] 0.52, 95% confidence interval [CI] 0.31-0.95, p = 0.03), migration (RR 0.07, 95% CI 0.03-0.16, p < 0.001), drainage failure (RR 0.62, 95% CI 0.39-0.96, p = 0.03), cuff extrusion (RR 0.40, 95% CI 0.21-0.74, p < 0.001), and complication-related removal (RR 0.53, 95% CI 0.44-0.64, p < 0.001).

DISCUSSION: Among the different types of PDCs, weighted catheters result in lower complication rates and superior long-term outcomes compared to non-weighted catheters. Other aspects of the catheter design do not significantly affect PDC outcomes.

PROTOCOL REGISTRATION: PROSPERO 2020 CRD42020158177.

© 2021. Italian Society of Nephrology.

Keywords: Coiled catheter; Double-cuff catheter; Self-locating catheter; Single-cuff catheter; Swan-neck catheter; Tenckhoff catheter

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