A Technique to Eradicate Tunnel Infection without Peritoneal Dialysis Catheter Removal

Abstract

In two adolescents maintained on CAPD, infections of the peritoneal catheter tunnel were treated by an “unroofing” technique. The infections were eradicated without catheter removal or interruption of CAPD. Continuous ambulatory peritoneal dialysis (CAPD) has produced a dramatic improvement in the care of patients with end-stage renal disease. Peritonitis remains a major complication and the most common cause of CAPD failure (1–3). Most episodes of peritonitis can be attributed to a break in the technique of bag exchanges; however, tunnel infections are also implicated (3,4). Tunnel infections are difficult to cure and, if persistent, may make necessary the removal of an otherwise well functioning catheter. We describe two patients with tunnel infections that were eradicated after “unroofing” of the Tenckhoff catheter.