Cochrane · systematic review · CD004680
Catheter type, placement and insertion techniques for preventing catheter‐related infections in chronic peritoneal dialysis patients
Htay, H, Johnson, DW, Craig, JC, et al. · Cochrane Database of Systematic Reviews · 2019 · Cochrane Library
Kidney and TransplantAMSTAR 2: not assessed
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
35
current version
GRADE rated
35
No studies
0
Included studies
NR
No studies 0 · 0%Ungraded 0 · 0%Very low 11 · 31.4%Low 9 · 25.7%Moderate 15 · 42.9%High 0 · 0%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Questions and results
Laparoscopy versus laparotomy for preventing catheter‐related infections in chronic peritoneal dialysis patients
Population: chronic peritoneal dialysis patients
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Peritonitis Laparoscopy vs laparotomy | RR 0.9 [0.59, 1.35] | 4 studies · 315 participants | Moderate |
Peritonitis rate (patient‐months) Laparoscopy vs laparotomy | RR 0.89 [0.39, 2.07] | 1 study · 375 participants | Very low Downgraded: imprecision |
Exit‐site/tunnel infection Laparoscopy vs laparotomy | RR 1 [0.43, 2.31] | 3 studies · 270 participants | Low Downgraded: imprecision |
Catheter removal or replacement Laparoscopy vs laparotomy | RR 1.2 [0.77, 1.86] | 3 studies · 167 participants | Low Downgraded: imprecision |
Technique failure Laparoscopy vs laparotomy | RR 0.71 [0.47, 1.08] | 4 studies · 283 participants | Low Downgraded: imprecision |
Death (all causes) Laparoscopy vs laparotomy | RR 1.26 [0.72, 2.2] | 3 studies · 270 participants | Moderate |
Buried (subcutaneous) versus non‐buried catheter for preventing catheter‐related infections in chronic peritoneal dialysis patients
Population: chronic peritoneal dialysis patients
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Peritonitis rate (patient‐months) Buried (subcutaneous) vs non‐buried catheter | RR 1.16 [0.37, 3.6] | 2 studies · 2511 participants | Very low Downgraded: imprecision, inconsistency |
Exit‐site/tunnel infection rate (patient‐months) Buried (subcutaneous) vs non‐buried catheter | RR 1.15 [0.39, 3.42] | 2 studies · 2511 participants | Very low Downgraded: imprecision, inconsistency |
Technique failure Buried (subcutaneous) vs non‐buried catheter | RR 0.73 [0.34, 1.55] | 1 study · 60 participants | Very low Downgraded: imprecision, inconsistency |
Death (all causes) Buried (subcutaneous) vs non‐buried catheter | RR 0.9 [0.39, 2.08] | 2 studies · 119 participants | Moderate Downgraded: imprecision, inconsistency |
Midline versus lateral insertion for preventing catheter‐related infections in chronic peritoneal dialysis patients
Population: chronic peritoneal dialysis patients
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Peritonitis Midline vs lateral insertion | RR 0.65 [0.32, 1.33] | 2 studies · 120 participants | Moderate |
Exit‐site/tunnel infection Midline vs lateral insertion | RR 0.56 [0.12, 2.58] | 2 studies · 120 participants | Low Downgraded: imprecision |
Catheter removal or replacement Midline vs lateral insertion | RR 0.57 [0.33, 0.98] | 1 study · 83 participants | Very low Downgraded: imprecision |
Death (all causes) Midline vs lateral insertion | RR 8.5 [0.5, 143.32] | 1 study · 37 participants | Very low Downgraded: imprecision |
Percutaneous insertion versus open surgery for preventing catheter‐related infections in chronic peritoneal dialysis patients
Population: chronic peritoneal dialysis patients
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Exit‐site/tunnel infection Percutaneous insertion vs open surgery | RR 0.16 [0.02, 1.3] | 2 studies · 96 participants | Moderate |
Catheter removal or replacement Percutaneous insertion vs open surgery | RR 0.24 [0.03, 2.04] | 1 study · 61 participants | Very low Downgraded: imprecision |
Straight versus coiled catheters for preventing catheter‐related infections in chronic peritoneal dialysis patients
Population: chronic peritoneal dialysis patients
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Peritonitis Straight vs coiled catheters | RR 1.04 [0.82, 1.31] | 9 studies · 818 participants | Moderate |
Peritonitis rate (patient‐months) Straight vs coiled catheters | RR 0.91 [0.68, 1.21] | 5 studies · 5882 participants | Moderate |
Exit‐site/tunnel infection Straight vs coiled catheters | RR 1.12 [0.94, 1.34] | 10 studies · 826 participants | Moderate |
Exit‐site/tunnel infection rate (patient‐months) Straight vs coiled catheters | RR 1.05 [0.77, 1.43] | 4 studies · 5286 participants | Moderate |
Catheter removal or replacement Straight vs coiled catheters | RR 1.11 [0.73, 1.66] | 9 studies · 713 participants | Very low |
Technique failure Straight vs coiled catheters | RR 0.82 [0.51, 1.31] | 4 studies · 442 participants | Moderate |
Death (all causes) Straight vs coiled catheters | RR 0.95 [0.62, 1.46] | 8 studies · 703 participants | Low |
Tenckhoff catheter with artificial curve at tunnel tract versus swan‐neck for preventing catheter‐related infections in chronic peritoneal dialysis patients
Population: preventing catheter‐related infections in chronic peritoneal dialysis patients
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Peritonitis Tenckhoff catheter with artificial curve at tunnel tract vs swan‐neck | RR 1.29 [0.85, 1.96] | 2 studies · 140 participants | Low Downgraded: imprecision |
Peritonitis rate (patient‐months) Tenckhoff catheter with artificial curve at tunnel tract vs swan‐neck | RR 1.22 [0.54, 2.75] | 2 studies · 2535 participants | Low Downgraded: imprecision, inconsistency |
Exit‐site/tunnel infection Tenckhoff catheter with artificial curve at tunnel tract vs swan‐neck | RR 0.96 [0.77, 1.21] | 2 studies · 140 participants | Moderate Downgraded: imprecision, inconsistency |
Exit‐site/tunnel infection rate (patient‐months) Tenckhoff catheter with artificial curve at tunnel tract vs swan‐neck | RR 0.67 [0.5, 0.9] | 2 studies · 2535 participants | Moderate Downgraded: imprecision, inconsistency |
Catheter removal or replacement Tenckhoff catheter with artificial curve at tunnel tract vs swan‐neck | RR 0.85 [0.42, 1.72] | 2 studies · 140 participants | Moderate Downgraded: imprecision, inconsistency |
Technique failure Tenckhoff catheter with artificial curve at tunnel tract vs swan‐neck | RR 0.64 [0.26, 1.58] | 2 studies · 140 participants | Moderate Downgraded: imprecision, inconsistency |
Death (all causes) Tenckhoff catheter with artificial curve at tunnel tract vs swan‐neck | RR 0.74 [0.27, 2.03] | 2 studies · 140 participants | Low Downgraded: imprecision |
Self‐locating versus straight Tenckhoff catheter for preventing catheter‐related infections in chronic peritoneal dialysis patients
Population: chronic peritoneal dialysis patients
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Peritonitis Self‐locating vs straight Tenckhoff catheter | RR 1.13 [0.86, 1.49] | 1 study · 78 participants | Very low Downgraded: imprecision |
Exit‐site/tunnel infection Self‐locating vs straight Tenckhoff catheter | RR 0.95 [0.37, 2.45] | 1 study · 78 participants | Very low Downgraded: imprecision |
Catheter removal or replacement Self‐locating vs straight Tenckhoff catheter | RR 0.32 [0.03, 3.06] | 2 studies · 139 participants | Very low Downgraded: imprecision, inconsistency |
Technique failure Self‐locating vs straight Tenckhoff catheter | RR 0.64 [0.39, 1.04] | 2 studies · 139 participants | Moderate Downgraded: imprecision, inconsistency |
Death (all causes) Self‐locating vs straight Tenckhoff catheter | RR 1.02 [0.11, 9.75] | 2 studies · 139 participants | Low Downgraded: imprecision, inconsistency |