© 2015 Wichtg Publishing JVA ISSN 1129-7298 J Vasc Access 2015; 16 (Suppl 9): S68-S72 ORIGINAL ARTICLE between centers, and suggested that such variability is more closely correlated with operator and center characteristcs than with catheter design. Catheter placement techniques can also infuence outcomes (6). Compared with hemodialysis catheters and more in general to hemodialysis access, including Arterio-venous (AV) fstulae, performance of the PD catheter as a form of dialysis access is excellent. In fact, Singh et al (7) showed a 3-year PD catheter survival of 91%: only PD catheter re- lated noninfectous problems were signifcantly associated with catheter failure. Other factors such as age, gender, race, body mass index (BMI), diabetc status, comorbidi- tes, previous abdominal surgeries, peritoneal infectons, or exit site/tunnel infectons did not afect the PD catheter survival. Corresponding survival data for hemodialysis cath- eter are difcult to obtain, because catheters are usually re- moved when an arteriovenous access is created. In a study on patents with permanent hemodialysis catheters and no possibility to create an arteriovenous access, hemodialysis catheter survival rate has been reported as low as 43% at 12 months (8). When considering the relatonship between PD catheter type and outcomes, we should keep in mind the diferent types of available PD catheters (4) (Tab. II), those that are most commonly used in clinical practce, and the available head-to-head comparisons in the literature. The main difer- ences in PD catheter design include the number of cufs, the shape of subcutaneous tract (straight vs. swan neck), and the shape of intra-peritoneal tract (straight vs. coiled). DOI: 10.5301/jva.5000369 Type of peritoneal dialysis catheter and outcomes Maurizio Gallieni 1,2 , Antonino Giordano 1 , Cristna Pinerolo 1 , Maurizio Cariat 3 1 Nephrology and Dialysis Unit, Ospedale San Carlo Borromeo, Milan - Italy 2 Department of Clinical and Biomedical Sciences “Luigi Sacco”, University of Milan, Milan - Italy 3 Department of Diagnostc Sciences, Division of Radiology and Interventonal Radiology, Ospedale San Carlo Borromeo, Milan - Italy Introducton In peritoneal dialysis (PD), a well-functoning catheter is of great importance, because a dysfunctonal catheter may be associated with incidence of peritonits, efciency of dialysis, and the overall quality of treatment, representng one of the main barriers to optmal use of PD (1). About 30% of drop- out cases from PD to hemodialysis are due to catheter failure (2). More recent data from the NECOSAD Study (3) confrmed that early dropout was related to PD catheter dysfuncton. In partcular, peritoneal catheter complicatons accounted for 40% of transfers to hemodialysis during the frst 3 months, although dropout rates were reduced to 25% afer 2 years. Good catheter functon is not only related to health person- nel dependent factors (catheter care, implantaton technique) but also to catheter features (4) (Tab. I). Flanigan et al (5) found that there is a substantal variability in catheter outcomes ABSTRACT In peritoneal dialysis (PD), a well-functoning catheter is of great importance, because a dysfunctonal catheter may be associated with incidence of peritonits, efciency of dialysis, and to the overall quality of treatment, rep- resentng one of the main barriers to optmal use of PD. When considering the relatonship between PD catheter type and outcomes, we should keep in mind the diferent types of available PD catheters, those that are most commonly used in clinical practce, and the available head-to-head comparisons in the literature. The main difer- ences in PD catheter design include the number of cufs, the shape of subcutaneous tract (straight vs. swan neck), and the shape of intraperitoneal tract (straight vs. coiled). The availability of the best catheter design and materials, along with a skillful management of PD access, may have the greatest impact on long-term patent outcome on PD. It is now established that the use of straight catheters may improve outcomes and technique survival, but further advances in PD catheter technology can po- tentally improve technique survival. The self-locatng PD catheter is a well established device that has not been fully studied and it may represent, based on the available observatonal evidence and on the clinical experience, an already existng technological advance deserving further studies. Keywords: Catheter, Complicatons, Design, Materials, Peritoneal dialysis, Surgery Accepted: January 7, 2015 Published online: March 8, 2015 Corresponding author: Maurizio Gallieni, MD Nephrology and Dialysis Unit Ospedale San Carlo Borromeo University of Milan Via Pio II 3 - 20153 Milan, Italy maurizio.gallieni@unimi.it