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

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Abstract
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.