Official reprint from UpToDate®
www.uptodate.com ©2018 UpToDate, Inc. and/or its affiliates. All Rights Reserved.

Noninfectious complications of peritoneal dialysis catheters

Rebecca J Schmidt, DO, FACP
Jean L Holley, MD, FACP
Section Editor
Steve J Schwab, MD
Deputy Editors
Alice M Sheridan, MD
Wenliang Chen, MD, PhD


The most frequent and important complication of peritoneal dialysis catheters is infection, which may result in catheter loss and discontinuation of peritoneal dialysis [1,2]. However, some evidence suggests that the transfer to hemodialysis for these reasons may be decreasing. (See "Clinical manifestations and diagnosis of peritonitis in peritoneal dialysis".)

There are also significant noninfectious complications of peritoneal dialysis catheters. These include [3,4]:

Outflow failure

Pericatheter leak

Abdominal wall herniation

To continue reading this article, you must log in with your personal, hospital, or group practice subscription. For more information on subscription options, click below on the option that best describes you:

Subscribers log in here

Literature review current through: Dec 2017. | This topic last updated: Feb 23, 2016.
The content on the UpToDate website is not intended nor recommended as a substitute for medical advice, diagnosis, or treatment. Always seek the advice of your own physician or other qualified health care professional regarding any medical questions or conditions. The use of this website is governed by the UpToDate Terms of Use ©2018 UpToDate, Inc.
  1. Holley JL, Praino BM. Complications of peritoneal dialysis: Diagnosis and management. Semin Dial 1990; 3:245.
  2. Bender FH. Avoiding harm in peritoneal dialysis patients. Adv Chronic Kidney Dis 2012; 19:171.
  3. Teitelbaum I, Burkart J. Peritoneal dialysis. Am J Kidney Dis 2003; 42:1082.
  4. McCormick BB, Bargman JM. Noninfectious complications of peritoneal dialysis: implications for patient and technique survival. J Am Soc Nephrol 2007; 18:3023.
  5. Leehey DJ, Ash SR, Daugirdas JT. Peritoneal access devices. In: Handbook of Dialysis, 4th ed., Daugirdas JT, Blake PG, Ing TS (Eds), Lippincott, Williams & Wilkins, Philadelphia 2007. p.356.
  6. Fleisher AG, Kimmelstiel FM, Lattes CG, Miller RE. Surgical complications of peritoneal dialysis catheters. Am J Surg 1985; 149:726.
  7. Kimmelstiel FM, Miller RE, Molinelli BM, Lorch JA. Laparoscopic management of peritoneal dialysis catheters. Surg Gynecol Obstet 1993; 176:565.
  8. Allon M, Soucie JM, Macon EJ. Complications with permanent peritoneal dialysis catheters: experience with 154 percutaneously placed catheters. Nephron 1988; 48:8.
  9. Adamson AS, Kelleher JP, Snell ME, Hulme B. Endoscopic placement of CAPD catheters: a review of one hundred procedures. Nephrol Dial Transplant 1992; 7:855.
  10. Mellotte GJ, Ho CA, Morgan SH, et al. Peritoneal dialysis catheters: a comparison between percutaneous and conventional surgical placement techniques. Nephrol Dial Transplant 1993; 8:626.
  11. Nahman NS Jr, Middendorf DF, Bay WH, et al. Modification of the percutaneous approach to peritoneal dialysis catheter placement under peritoneoscopic visualization: clinical results in 78 patients. J Am Soc Nephrol 1992; 3:103.
  12. Copley JB, Lindberg JS, Back SN, Tapia NP. Peritoneoscopic placement of Swan neck peritoneal dialysis catheters. Perit Dial Int 1996; 16 Suppl 1:S330.
  13. Moncrief JW, Popovich RP, Moncrief B, et al. Moncrief-Popovich catheter: A new access technique for patients on continuous ambulatory peritoneal dialysis. Perit Dial Int 1993; 13:S6.
  14. Prischl FC, Wallner M, Kalchmair H, et al. Initial subcutaneous embedding of the peritoneal dialysis catheter--a critical appraisal of this new implantation technique. Nephrol Dial Transplant 1997; 12:1661.
  15. Farooq MM, Freischlag JA. Peritoneal dialysis: an increasingly popular option. Semin Vasc Surg 1997; 10:144.
  16. Robison RJ, Leapman SB, Wetherington GM, et al. Surgical considerations of continuous ambulatory peritoneal dialysis. Surgery 1984; 96:723.
  17. Sahani MM, Mukhtar KN, Boorgu R, et al. Tissue plasminogen activator can effectively declot peritoneal dialysis catheters. Am J Kidney Dis 2000; 36:675.
  18. Shea M, Hmiel SP, Beck AM. Use of tissue plasminogen activator for thrombolysis in occluded peritoneal dialysis catheters in children. Adv Perit Dial 2001; 17:249.
  19. Jaques P, Richey W, Mandel S. Tenckhoff peritoneal dialysis catheter: cannulography and manipulation. AJR Am J Roentgenol 1980; 135:83.
  20. Moss JS, Minda SA, Newman GE, et al. Malpositioned peritoneal dialysis catheters: a critical reappraisal of correction by stiff-wire manipulation. Am J Kidney Dis 1990; 15:305.
  21. Dobrashian RD, Conway B, Hutchison A, et al. The repositioning of migrated Tenckhoff continuous ambulatory peritoneal dialysis catheters under fluoroscopic control. Br J Radiol 1999; 72:452.
  22. Simons ME, Pron G, Voros M, et al. Fluoroscopically-guided manipulation of malfunctioning peritoneal dialysis catheters. Perit Dial Int 1999; 19:544.
  23. McLaughlin K, Jardine AG. Closed stiff-wire manipulation of malpositioned Tenckhoff catheters offers a safe and effective way of prolonging peritoneal dialysis. Int J Artif Organs 2000; 23:219.
  24. Miller M, McCormick B, Lavoie S, et al. Fluoroscopic manipulation of peritoneal dialysis catheters: outcomes and factors associated with successful manipulation. Clin J Am Soc Nephrol 2012; 7:795.
  25. Yilmazlar T, Kirdak T, Bilgin S, et al. Laparoscopic findings of peritoneal dialysis catheter malfunction and management outcomes. Perit Dial Int 2006; 26:374.
  26. Xie J, Kiryluk K, Ren H, et al. Coiled versus straight peritoneal dialysis catheters: a randomized controlled trial and meta-analysis. Am J Kidney Dis 2011; 58:946.
  27. Ash SR. Chronic peritoneal dialysis catheters: Effects of catheter design, materials, and location. Semin Dial 1990; 3:39.
  28. Owens LV, Brader AH. Laparoscopic salvage of Tenckhoff catheters. Surg Endosc 1995; 9:517.
  29. Cronen PW, Moss JP, Simpson T, et al. Tenckhoff catheter placement: surgical aspects. Am Surg 1985; 51:627.
  30. Zadrozny D, Lichodziejewska-Niemierko M, Draczkowski T, et al. Laparoscopic approach for dysfunctional Tenckhoff catheters. Perit Dial Int 1999; 19:170.
  31. Goh YH. Omental folding: a novel laparoscopic technique for salvaging peritoneal dialysis catheters. Perit Dial Int 2008; 28:626.
  32. Newman LN, Tessman M, Hanslik T, et al. A retrospective view of factors that affect catheter healing: four years of experience. Adv Perit Dial 1993; 9:217.
  33. Leblanc M, Ouimet D, Pichette V. Dialysate leaks in peritoneal dialysis. Semin Dial 2001; 14:50.
  34. Eklund BH. Surgical implantation of CAPD catheters: presentation of midline incision-lateral placement method and a review of 110 procedures. Nephrol Dial Transplant 1995; 10:386.
  35. Cruz C. Cruz catheter: implantation technique and clinical results. Perit Dial Int 1994; 14 Suppl 3:S59.
  36. Pastan S, Gassensmith C, Manatunga AK, et al. Prospective comparison of peritoneoscopic and surgical implantation of CAPD catheters. ASAIO Trans 1991; 37:M154.
  37. Bullmaster JR, Miller SF, Finley RK Jr, Jones LM. Surgical aspects of the Tenckhoff peritoneal dialysis catheter. A 7 year experience. Am J Surg 1985; 149:339.
  38. Swartz RD. Chronic peritoneal dialysis: mechanical and infectious complications. Nephron 1985; 40:29.
  39. Swartz R, Messana J, Rocher L, et al. The curled catheter: dependable device for percutaneous peritoneal access. Perit Dial Int 1990; 10:231.
  40. Gadallah MF, Pervez A, el-Shahawy MA, et al. Peritoneoscopic versus surgical placement of peritoneal dialysis catheters: a prospective randomized study on outcome. Am J Kidney Dis 1999; 33:118.
  41. Vaux EC, Torrie PH, Barker LC, et al. Percutaneous fluoroscopically guided placement of peritoneal dialysis catheters--a 10-year experience. Semin Dial 2008; 21:459.
  42. Yerram P, Gill A, Prowant B, et al. A 9-year survival analysis of the presternal Missouri swan-neck catheter. Adv Perit Dial 2007; 23:90.
  43. de Alvaro F, Selgas R, Bajo MA, et al. Moncrief's technique for peritoneal catheter placement: experience of a CAPD unit. Adv Perit Dial 1994; 10:199.
  44. Stuart S, Booth TC, Cash CJ, et al. Complications of continuous ambulatory peritoneal dialysis. Radiographics 2009; 29:441.
  45. Tzamaloukas AH, Gibel LJ, Eisenberg B, et al. Early and late peritoneal dialysate leaks in patients on CAPD. Adv Perit Dial 1990; 6:64.
  46. Ash, SR, Daugirdas, JT. Peritoneal dialysis access. In: Handbook of Dialysis, Daugirdas, JT, Ing, TS (Eds), Little, Brown, Boston 1994. p.274.
  47. Twardowski ZJ, Prowant BF, Khanna R, et al. Long-term experience with Swan Neck Missouri catheters. ASAIO Trans 1990; 36:M491.
  48. Asif A, Byers P, Vieira CF, et al. Peritoneoscopic placement of peritoneal dialysis catheter and bowel perforation: experience of an interventional nephrology program. Am J Kidney Dis 2003; 42:1270.
  49. Mital S, Fried LF, Piraino B. Bleeding complications associated with peritoneal dialysis catheter insertion. Perit Dial Int 2004; 24:478.