Peritoneal Dialysis Catheter Design: Variants and Clinical Implications

The success of peritoneal dialysis (PD) relies imperatively on the presence of a safe and well-functioning peritoneal access. The ideal catheter should be easy to position and durable, comfortable and practical to use, have minimal aesthetic impact and present low infectious and mechanical complications. Originally, the catheter that came closest to these characteristics was designed by Tenckhoff at the end of the 1960s. Over the next fifty years, different types of devices were developed with the aim of improving their efficiency and at the same time reducing the associated complications. Overall, none of these catheters has demonstrated a clear superiority over the Tenckhoff catheter and yet up to 30% of PD discontinuations are due to access-related complications. However, nowadays the wide range of existing models bestow the possibility of a personalized choice. This approach, together with the placement technique and the experience of the centre, would allow maximizing the benefits deriving from specific features of the PD catheter in relation to peculiar conditions of the recipient. Therefore, for clinicians involved in the positioning and care of peritoneal access, understanding the principles underlying the different configurations of the PD catheter is necessary to establish a “case by case” approach.