Subcutaneous Peritoneal Catheter: 2½Years Experience

A subcutaneous peritoneal catheter (SCPC) developed at the University of Utah has been used for chronic peritoneal dialysis in this center during the last 2% years. Fifty-six SCPC's were implanted in 48 patients for a total of 11, 260 days (30.8 patient years). The SCPC's were used for peritoneal dialysis for 7831 days (21.4 patient years) for 3356 peritoneal dialyses, the longest for 778 days (2.1 years). The SCPC remained functioning in ten patients during periods of nonuse, e. g., successful renal transplant, for 1908 days (5.2 patient years). The functional status of the SCPC was unknown in five patients lost to follow-up for 809 days. Functional outflow obstruction episodes occurred 39 times during peritoneal dialysis (1 per 6.6 patient months); 29 of these episodes were corrected by either bedside maneuvers or minor surgical procedures. Five out of ten SCPC's removed for obstruction were successfully replaced. Twenty-nine infections occurred (0.80% of peritoneal dialyses), resulting in nine SCPC removals (three successfully replaced). In spite of the necessary insertion of a 14-g needle for each peritoneal dialysis, the SCPC was well accepted by the patients, mostly because of the reduced care required and the increased personal freedom gained during the interdialytic interval. The long periods of patency during nonuse (up to 397 days) further indicated the possible usefulness of the SCPC as a back-up device for hemodialysis patients. This could greatly reduce the problems associated with temporary loss of blood access in patients on hemodialysis.