What are the concerns / possible complications of a long-unused PD catheter? After many discussions and many, many no-shows and missed training appointments, we are definitely not doing PD. However, this patient has also no-showed / canceled the appointments for the catheter to come out. It’s been in for months, approaching a year. I will, of course, keep trying to get her in for a catheter removal, but what should I be on the lookout for?

Questions About PD

Caroline H, Doctor/MD from Boston, MA asked
What are the concerns / possible complications of a long-unused PD catheter? After many discussions and many, many no-shows and missed training appointments, we are definitely not doing PD. However, this patient has also no-showed / canceled the appointments for the catheter to come out. It’s been in for months, approaching a year. I will, of course, keep trying to get her in for a catheter removal, but what should I be on the lookout for?

1 answer

Nurse Canada with members of the ISPD Nursing Committee June 23, 2024

We thank you for your question. According to the information you provided, there are no plans for the patient to be performing PD.
However, until the PD catheter is removed, the main risk is for PD catheter exit-site infection and subsequent peritonitis, therefore we would suggest to inform the patient and document that she needs to let the home dialysis nurses know if she does develop any signs of infection at the PD catheter exit-site or signs and symptoms of peritonitis (1, page 4). Ideally, the patient would be performing routine PD catheter exit-site care, according to your unit’s protocol.
There are a few published case reports, primarily in dormant (not being used) PD catheters, of the rare complication of PD catheter-related bowel erosion (2).
We trust this information is helpful!
 
1.Figueiredo AE, Hurst H, Neumann JL, Chow JS, Walker R, Woodhouse J, Punzalan S, Tomlins M, Cave K, Brunier G. Nursing management of catheter-related non-infectious complications of PD: Your questions answered. Peritoneal Dialysis International. 2024 May 21:08968608241246449. Available at: https://journals.sagepub.com/doi/abs/10.1177/08968608241246449
 
2.Wang R, Chen Z, Wang J, Zhang X, Shou Z, Chen J. Delayed bowel perforation in a peritoneal dialysis patient: a case report and literature review. Peritoneal Dialysis International. 2014 Jun;34(4):460-6. doi: 10.3747/pdi.2012.00345. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4079495/
 

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