Management of chronic peritoneal catheter malfunction.

This paper presents a modification of Tenckhoff's insertion procedure for chronic peritoneal dialysis catheters and reviews the results of a technique of management of catheter malfunction by manipulation which obviates the need for catheter replacement. 43 catheters in 33 patients were observed for no less than 1 year. Catheters which malfunctioned within 3 weeks benefited only marginally from manipulation. In those catheters which functioned for more than 3 weeks, manipulation extended mean survival time by 103% (8.5-17.3 months) and overall survival did not differ statistically from catheters not requiring manipulation. The technique is safe and simple and contributes to the effective management of patients undergoing chronic peritoneal dialysis.