Semin intervent Radiol 2022; 39(01): 040-046
DOI: 10.1055/s-0041-1741484
Review Article

Complications of Percutaneous Peritoneal Dialysis Catheter

Bharvi P. Oza-Gajera
1   Department of Medicine, University of Cincinnati, Cincinnati, Ohio
Ahmed K. Abdel-Aal
2   Department of Interventional Radiology, University of Texas at Houston, Houston, Texas
Ammar Almehmi
3   Department of Radiology and Medicine, University of Alabama at Birmingham, Birmingham, Alabama
› Author Affiliations


A functional peritoneal dialysis (PD) catheter is the cornerstone for the success of renal replacement therapy. This success is largely dependent on adhering to best practices during catheter insertion, which starts with a comprehensive preoperative evaluation that helps in determining the catheter configuration type and both entry and exit sites. Additionally, following the best practice guidelines during PD catheter insertion minimizes undesirable complications and provides a durable functional access for dialysis. However, adverse complications are still encountered despite abiding with these clinical guidelines. These complications are categorized into mechanical and infectious groups. The description and management of these adverse events are discussed in detail in this article with particular attention to the technical pitfalls that can occur during catheter insertion. Avoiding these pitfalls can minimize PD catheter complications and potentially improve clinical outcomes.

Authors' Contributions

All authors contributed equally to this article. All authors read and approved the final manuscript.

Publication History

Article published online:
18 February 2022

© 2022. Thieme. All rights reserved.

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  • References

  • 1 Crabtree JH. Peritoneal dialysis catheter implantation: avoiding problems and optimizing outcomes. Semin Dial 2015; 28 (01) 12-15
  • 2 Crabtree JH, Chow KM. Peritoneal dialysis catheter insertion. Semin Nephrol 2017; 37 (01) 17-29
  • 3 Lok CE, Moist L. KDOQI 2019 vascular access guidelines: What is new?. Adv Chronic Kidney Dis 2020; 27 (03) 171-176
  • 4 Crabtree JH, Shrestha BM, Chow KM. et al. Creating and maintaining optimal peritoneal dialysis access in the adult patient: 2019 update. Perit Dial Int 2019; 39 (05) 414-436
  • 5 Almehmi A. Interventional Nephrology Primer: Part 2: Peritoneal Dialysis Catheter ASDIN Endorsed Material. 2020
  • 6 Fujiwara M, Soda T, Okada T, Kanamaru H, Inoue T, Ogawa O. Bowel perforation by a peritoneal dialysis catheter: report of two cases. BMC Nephrol 2017; 18 (01) 312
  • 7 Asif A. Approach to a patient with visceral perforation. In: Yevzlin AS. et al (eds.) Interventional Nephrology. New York: Springer Science + Business Media; 2014: 319-320
  • 8 Narayan R, Fried T, Chica G, Schaefer M, Mullins D. Minimally invasive fluoroscopic percutaneous peritoneal dialysis catheter salvage. Clin Kidney J 2014; 7 (03) 264-268
  • 9 Goldstein M, Carrillo M, Ghai S. Continuous ambulatory peritoneal dialysis-a guide to imaging appearances and complications. Insights Imaging 2013; 4 (01) 85-92
  • 10 Jheng JS, Chang CT, Huang CC. Omental wrapping of a peritoneal dialysis catheter. Kidney Int 2012; 82 (07) 827
  • 11 Yilmaz E, Kurultak I, Ustundag S, Tuncbilek N. Computed tomography findings of peritoneal dialysis related complications. EJMI 2019; 3 (01) 19-22
  • 12 Nakayama T, Hashimoto K, Kiriyama T, Hirano K. Optimal imaging conditions for the diagnosis of pleuroperitoneal communication. BMJ Case Rep 2019; 12 (03) e228940
  • 13 Debowski JA, Wærp C, Kjellevold SA, Abedini S. Cuff extrusion in peritoneal dialysis: single-centre experience with the cuff-shaving procedure in five patients over a 4-year period. Clin Kidney J 2017; 10 (01) 131-134
  • 14 Crabtree JH, Burchette RJ. Surgical salvage of peritoneal dialysis catheters from chronic exit-site and tunnel infections. Am J Surg 2005; 190 (01) 4-8