{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T04:53:47Z","timestamp":1777870427394,"version":"3.51.4"},"reference-count":9,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2021,7,8]],"date-time":"2021-07-08T00:00:00Z","timestamp":1625702400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2021,7,8]],"date-time":"2021-07-08T00:00:00Z","timestamp":1625702400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100002345","name":"Eberhard Karls Universit\u00e4t T\u00fcbingen","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100002345","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["J Nephrol"],"published-print":{"date-parts":[[2022,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>In patients with obesity and end-stage kidney disease, implantation of the peritoneal dialysis (PD) catheter may be complicated by increased abdominal circumference or skin folds. Relocation of the implantation site to the upper abdomen could solve this problem. However, this would require an extended catheter.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We developed an extended PD catheter based on a swan neck Missouri PD catheter with the help of two adaptors and a straight intraperitoneal extension segment. The extended catheter was assembled intraoperatively, and its length was adjusted individually to ensure correct positioning. After the operation, PD was commenced and handled as usual.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      In the period from 2011 to 2021, we implanted 31 extended PD catheters in 29 patients (38% men) with end-stage renal failure and obesity. Median age was 53 (range 28\u201377) years and body mass index was 35.5 (range 26.4\u201346.9) kg\/m\n                      <jats:sup>2<\/jats:sup>\n                      . The postoperative course was unremarkable except for seroma formation in one patient and dialysate leakage in another. Continuous ambulatory peritoneal dialysis (CAPD) was initiated in 20 and APD in 9 patients. The achieved median Kt\/V was 2.10 (range 1.50\u20133.10). During the follow-up period lasting up to 51\u00a0months, there was one case of intraperitoneal catheter disconnection due to an avoidable handling error. The peritonitis rate was 1:40\u00a0months. The 1- and 2-year catheter survival was 92% and 67%, respectively, and paralleled patient survival.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>When using a PD catheter with an intraperitoneal extension, PD catheter implantation can be relocated to the upper abdomen in patients with obesity, thus providing optimal position and easy surgical access.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s40620-021-01077-z","type":"journal-article","created":{"date-parts":[[2021,7,27]],"date-time":"2021-07-27T04:08:16Z","timestamp":1627358896000},"page":"311-316","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Intraperitoneal extension of the peritoneal dialysis catheter\u2014a new technique for catheter implantation in patients with obesity"],"prefix":"10.1093","volume":"35","author":[{"given":"Michael","family":"Sayer","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8880-4860","authenticated-orcid":false,"given":"Christian","family":"Thiel","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0402-7708","authenticated-orcid":false,"given":"Martin","family":"Schenk","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2301-4080","authenticated-orcid":false,"given":"Alfred","family":"K\u00f6nigsrainer","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9982-5093","authenticated-orcid":false,"given":"Nils","family":"Heyne","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1407-9023","authenticated-orcid":false,"given":"Andreas L.","family":"Birkenfeld","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3777-9316","authenticated-orcid":false,"given":"Ferruh","family":"Artunc","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7328-7589","authenticated-orcid":false,"given":"Karolin","family":"Thiel","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2021,7,8]]},"reference":[{"key":"1077_CR1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(16)30054-X","author":"Collaboration NCDRF","year":"2016","unstructured":"Collaboration NCDRF (2016) Trends in adult body-mass index in 200 countries from 1975 to 2014: a pooled analysis of 1698 population-based measurement studies with 19.2 million participants. Lancet. https:\/\/doi.org\/10.1016\/S0140-6736(16)30054-X","journal-title":"Lancet"},{"issue":"5","key":"1077_CR2","doi-asserted-by":"publisher","first-page":"1453","DOI":"10.1681\/ASN.2005111241","volume":"17","author":"HJ Kramer","year":"2006","unstructured":"Kramer HJ, Saranathan A, Luke A, Durazo-Arvizu RA, Guichan C, Hou S et al (2006) Increasing body mass index and obesity in the incident ESRD population. J Am Soc Nephrol 17(5):1453\u20131459","journal-title":"J Am Soc Nephrol"},{"issue":"2","key":"1077_CR3","doi-asserted-by":"publisher","first-page":"276","DOI":"10.2215\/CJN.10300819","volume":"15","author":"C Kennedy","year":"2020","unstructured":"Kennedy C, Bargman J (2020) Peritoneal dialysis in the obese patient. Clin J Am Soc Nephrol 15(2):276\u2013278","journal-title":"Clin J Am Soc Nephrol"},{"issue":"4","key":"1077_CR4","doi-asserted-by":"publisher","first-page":"1714","DOI":"10.1007\/s00464-017-5852-y","volume":"32","author":"MA Krezalek","year":"2018","unstructured":"Krezalek MA, Bonamici N, Kuchta K, Lapin B, Carbray J, Denham W et al (2018) Peritoneal dialysis catheter function and survival are not adversely affected by obesity regardless of the operative technique used. Surg Endosc 32(4):1714\u20131723","journal-title":"Surg Endosc"},{"key":"1077_CR5","first-page":"316","volume":"8","author":"ZJ Twardowski","year":"1992","unstructured":"Twardowski ZJ, Nichols WK, Nolph KD, Khanna R (1992) Swan neck presternal (\u201cbath tub\u201d) catheter for peritoneal dialysis. 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Perit Dial Int 30(1):46\u201355","journal-title":"Perit Dial Int"},{"issue":"5","key":"1077_CR8","doi-asserted-by":"publisher","first-page":"414","DOI":"10.3747\/pdi.2018.00232","volume":"39","author":"JH Crabtree","year":"2019","unstructured":"Crabtree JH, Shrestha BM, Chow KM, Figueiredo AE, Povlsen JV, Wilkie M et al (2019) Creating and maintaining optimal peritoneal dialysis access in the adult patient: 2019 update. Perit Dial Int 39(5):414\u2013436","journal-title":"Perit Dial Int"},{"issue":"6","key":"1077_CR9","doi-asserted-by":"publisher","first-page":"1383","DOI":"10.1159\/000503288","volume":"44","author":"F Artunc","year":"2019","unstructured":"Artunc F, Rueb S, Thiel K, Thiel C, Linder K, Baumann D et al (2019) Implementation of urgent start peritoneal dialysis reduces hemodialysis catheter use and hospital stay in patients with unplanned dialysis start. Kidney Blood Press Res 44(6):1383\u20131391","journal-title":"Kidney Blood Press Res"}],"container-title":["Journal of Nephrology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s40620-021-01077-z.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s40620-021-01077-z\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s40620-021-01077-z.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T15:58:48Z","timestamp":1777564728000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/joneph\/article\/35\/1\/311\/8439596"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,7,8]]},"references-count":9,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2022,1]]}},"alternative-id":["1077"],"URL":"https:\/\/doi.org\/10.1007\/s40620-021-01077-z","relation":{},"ISSN":["1121-8428","1724-6059"],"issn-type":[{"value":"1121-8428","type":"print"},{"value":"1724-6059","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,7,8]]},"assertion":[{"value":"16 May 2021","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"18 May 2021","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"8 July 2021","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare no conflict of interest.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"The study was approved by the T\u00fcbingen University Ethics Committee (194\/2018BO).","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}},{"value":"All patients consented to participate.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent to participate"}},{"value":"Approved consent was provided by the daughter of the deceased patient in Fig.\u00a0\n                      \n                      .","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}}]}}