Relationship between peritoneal dialysis catheter line changes and PD associated peritonitis

Aim: To establish the relationship between Tenckhoff catheter routine line changes and the development of peritoneal dialysis (PD) associated peritonitis.

Background: Tenckhoff catheter extension line changes are a routine part of PD care. They are recommended to be completed at six monthly intervals as per manufacturer’s instructions. However, there is no published scientific evidence regarding Tenckhoff catheter line changes.

Methods: We performed a retrospective analysis of the Royal Hobart Hospital cohort of peritoneal dialysis patients from 2008–2014. We collected data regarding patient demographics, as well as for the dates of Tenckhoff catheter line changes and specifics regarding episodes of PD associated peritonitis. PD peritonitis associated with contaminated lines and subsequent line changes were excluded.

Results: A total of 69 patient-episodes of peritonitis occurred in the period between 2008–2014, in a cohort of 53 patients. Mean age of the overall cohort was 64 years. We excluded 25 episodes due to contamination or in the context of recent infection. Of these episodes, 24% (10 episodes) of peritonitis occurred in the first month of routine line change, in contrast to a median of 13% (6 episodes) in any of the later months prior to routine line change.

Conclusions: Tenckhoff catheter line changes may be temporally associated with an increased risk of PD associated peritonitis. Further investigation is required to optimise aseptic non-touch technique to reduce episodes of peritonitis.