0896-8608/01 $3.00 + .00 Copyright © 2001 International Society for Peritoneal Dialysis Printed in Canada. All rights reserved. Proceedings of the ISPD 2001 — The IXth Congress of the ISPD June 26 – 29, 2001, Montréal, Canada Peritoneal Dialysis International, Vol. 21 (2001), Supplement 3 S209 ♦ Objective: We analyzed malfunction rates (obstruction, omental wrapping, displacement) and catheter survival for self-locating catheters as compared with other Tenckhoff catheter designs. ♦ Patients and Methods: We conducted our survey at two centers, prospectively studying all self-locating catheters implanted from May 1997 to October 2000 and used for peri- toneal dialysis (PD). Tenckhoff catheters of other designs used previously in our units were used as the control group. We analyzed removal causes and catheter survival. ♦ Results: We studied 173 catheters (105 self-locating catheters, 53 straight catheters, and 15 coiled catheters) implanted in 139 patients (43% of them women) with a mean age of 53 ± 14 years. The analysis of catheter re- moval showed that 3 of 105 self-locating catheters, 3 of 15 coiled catheters, and 17 of 53 straight catheters were removed owing to malfunction (χ 2 : p = 0.0000). Kaplan– Meier curves showed that the bulk of removals for mal- function occurred within the first 3 months after PD start. The group of self-locating catheters showed better sur- vival (log-rank: p = 0.0009). Other causes for catheter re- moval included peritonitis (n = 22), exit-site infection alone (n = 4), and end of PD treatment (n = 66). No significant differences were seen in the annual peritonitis rate (straight-tip: 0.955 ± 2.315 episodes annually; coiled-tip: 0.651 ± 0.864 episodes annually; self-locating: 0.720 ± 1.417 episodes annually; t-test: p > 0.400). No gut or blad- der perforations were observed. ♦ Conclusion: In our survey, self-locating catheters were associated with better survival and fewer removals for mal- function than were Tenckhoff catheters of other designs. KEY WORDS: Catheter malfunction; self-locating catheter; peritoneal catheter. S ince the decline in the peritonitis rate following introduction of improved connection technology in peritoneal dialysis (PD), catheter-related problems have become a major concern. Catheter malfunction can lead to underdialysis and can result in permanent transfer to hemodialysis (HD) in up to 20% of all pa- tients who start renal replacement therapy on PD (1). Catheter variations—for example, coiled-tip, Swan- neck, Toronto Western Hospital, Ash, and others—have focused on reducing malfunction and preventing cath- eter-associated exit-site infection (ESI) and peritoni- tis (1). The self-locating catheter studied here is similar to a classic Tenckhoff. It was designed by Di Paolo et al (2). The difference occurs at the internal tip, where a 12-g tungsten weight has been added (Figure 1). Our objective in the present study was to analyze the malfunction rate (obstruction, omental wrapping, displacement) and catheter survival for this self- locating catheter as compared with other Tenckhoff catheter designs. PATIENTS TIENTS TIENTS TIENTS TIENTS AND METHODS AND METHODS AND METHODS AND METHODS AND METHODS Our study looked at 173 catheters implanted in 139 patients. It was conducted in two separate cen- Correspondence to: I. Minguela, Department of Nephrol- ogy, Hospital Txagorritxu, Jose Atxotegi s/n st., Vitoria–Gasteiz E-01.009 Spain. iminguela@htxa.osakidetza.net LOWER MALFUNCTION RATE WITH SELF-LOCATING CATHETERS Ignacio Minguela, 1 Manuel Lanuza, 2 Ramón Ruiz de Gauna, 1 Raquél Rodado, 2 Soledad Alegría, 2 Alberto J. Andreu, 2 María J. González, 2 Benigno Rodríguez, 3 Jose M. Vítores, 3 Teresa Castellanos, 1 Concepción Martínez, 1 Begoña Aurrekoetxea, 1 Alejandro Chena 1 Nephrology Department, 1 Hospital Txagorritxu, Vitoria; Nephrology Department, 2 University Hospital Virgen de la Arrixaca, Murcia; and Surgery Department, 3 Hospital Txagorritxu, Vitoria, Spain Figure 1 — The self-locating catheter. The tungsten weight can be observed at the end of the intraperitoneal segment.