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Peritoneal dialysis (PD) catheter placement technique may affect catheter survival, functionality and infection risk. The Moncrief-Popovich (subcutaneous burying or embedding) technique was developed to reduce exit-site/tunnel infections during the interval between insertion and first use.
Objective: Compare PD catheter survival, functionality and complication rates between conventional modified percutaneous placement and Moncrief-Popovich in adults initiating planned PD.
Brief methods: Prospective, randomized, parallel-arm study enrolling adult CKD patients scheduled for planned PD initiation and catheter placement at Hospital Civil de Guadalajara between Jan 2024 and Dec 2025. Patients randomized 1:1 to conventional modified percutaneous placement group or Moncrief-Popovich buried catheter group. Primary outcome is catheter survival/functionality during follow-up. Secondary outcomes include infectious and mechanical complications, peritonitis incidence, and need to change dialysis modality.
This prospective, randomized, comparative longitudinal study evaluates PD catheter survival and functionality in adult patients with advanced chronic kidney disease undergoing planned PD catheter placement at Hospital Civil de Guadalajara "Fray Antonio Alcalde" from January 2024 to December 2025. Eligible patients are randomized 1:1 to receive either the conventional modified percutaneous catheter placement (Group A) or the Moncrief-Popovich technique with subcutaneous burial of the distal catheter segment until exteriorization (Group B). Data are collected from medical records and nephrology clinic follow-up visits. Outcomes include catheter survival time, functional status at baseline and during follow-up, early and late infectious (exit-site infection, tunnel infection, peritonitis) and mechanical complications, and requirement for dialysis modality change due to catheter failure. Statistical analyses compare rates and time-to-event outcomes between groups; significance set at p < 0.05. Study procedures comply with institutional ethics oversight and informed consent requirements.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| CONVENTIONAL MODIFIED PERCUTANEOUS PLACEMENT | Active Comparator | Conventional Modified Percutaneous Placement: Description: Peritoneal dialysis catheter placed at bedside using the center's conventional modified percutaneous technique (nephrologist-performed), catheter externalized and tunneled per standard protocol; catheter used following standard healing period and center procedures. |
|
| MONCRIEF-POPOVICH TECHNIQUE | Experimental | Peritoneal dialysis catheter placed with subcutaneous burial or embedding of the external catheter segment (Moncrief-Popovich technique). Catheter remains embedded until planned exteriorization and initiation of dialysis per protocol; exteriorization performed for PD initiation. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Embedded Peritoneal catheter placement | Procedure | Peritoneal dialysis catheter placement using Moncrief-Popovich Technique performed by nephrologist |
|
| Measure | Description | Time Frame |
|---|---|---|
| PD catheter survival and functionality | Functionality assessed by ability to perform adequate PD exchanges and absence of mechanical obstruction to the end of follow-up | 12 months |
| Measure | Description | Time Frame |
|---|---|---|
| Peritonitis incidence | Number and rate of PD-related peritonitis episodes during follow-up | 12 months |
| Early infectious complications | Incidence of exit-site infection or tunnel infection within 30 days after insertion |
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Inclusion Criteria:
Exclusion Criteria:
Elimination Criteria:
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Hospital Civil de Guadalajara "Fray Antonio Alcalde" | Guadalajara | Jalisco | 44280 | Mexico |
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| ID | Term |
|---|---|
| D051436 | Renal Insufficiency, Chronic |
| ID | Term |
|---|---|
| D051437 | Renal Insufficiency |
| D007674 | Kidney Diseases |
| D014570 | Urologic Diseases |
| D052776 | Female Urogenital Diseases |
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| Modified Percutaneous PD catheter placement | Procedure | Peritoneal dialysis catheter placed at bedside using conventional modified percutaneous technique, catheter tunneled and externalized per standard protocol; catheter used following standard healing period and center procedures performed by nephrologist. |
|
| 30 days |
| Change of dialysis modality due to catheter failure | Proportion of patients requiring modality change to hemodialysis secondary to catheter-related issues | 12 months |
| Late infectious complications | Incidence of exit-site infection, tunnel infection beyond 30 days | 12 months |
| Adverse events related to placement procedure | Incidence of catheter migration, obstruction, leak, malfunction, bleeding, visceral injury, requiring intervention | 2 weeks |
| D005261 |
| Female Urogenital Diseases and Pregnancy Complications |
| D000091642 | Urogenital Diseases |
| D052801 | Male Urogenital Diseases |
| D002908 | Chronic Disease |
| D020969 | Disease Attributes |
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |