{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T23:11:09Z","timestamp":1777936269693,"version":"3.51.4"},"reference-count":23,"publisher":"SAGE Publications","issue":"4","license":[{"start":{"date-parts":[[2024,9,5]],"date-time":"2024-09-05T00:00:00Z","timestamp":1725494400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Vasc Access"],"published-print":{"date-parts":[[2025,7]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>The preferred techniques for peritoneal dialysis catheterization are uncertain. Catheter implantation with formation of an inferiorly-directed tunnel and exit site is widely recommended to reduce the risk of infective complications. We aimed to compare percutaneous peritoneal dialysis catheter insertion using an upwardly-directed tract to catheter insertion using a downwardly-directed tract.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>A retrospective cohort study was performed on consecutive peritoneal dialysis catheterizations over a 10-year period at a single centre. Participants were classified into two groups: catheter insertion with an upward tunnel and exit site versus insertion with a downward tunnel and exit site. The primary outcome was peritoneal dialysis catheter survival.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      There were 247 peritoneal dialysis catheters inserted during the study period. The median catheter survival was 18\u2009months, with no difference between the two groups (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.23). The 12-month catheter patency rates were 76% for catheters with an upward tract and 79% for catheters with a downward tract (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.15). Multivariate analysis identified no clinical factors predictive of catheter survival. A downward catheter tunnel and exit site was associated with an increased incidence of peritonitis (0.23 vs 0.11 episodes per year;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009\u2a7d\u20090.01).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>In this study, percutaneous peritoneal dialysis catheter insertion with an upward tunnel and exit site demonstrated similar catheter survival to insertion with a downward tunnel and exit site and was not associated with increased infections.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/11297298241277861","type":"journal-article","created":{"date-parts":[[2024,9,6]],"date-time":"2024-09-06T01:23:16Z","timestamp":1725585796000},"page":"1318-1323","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Peritoneal dialysis catheterization with an upward tunnel and exit site: An observational study"],"prefix":"10.1177","volume":"26","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0587-276X","authenticated-orcid":false,"given":"Julian","family":"Yaxley","sequence":"first","affiliation":[{"name":"Department of Nephrology, Cairns Hospital, Cairns, QLD, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tahira","family":"Scott","sequence":"additional","affiliation":[{"name":"Torres and Cape Hospital and Health Service, Cairns, QLD, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Harris","family":"Hakim","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Cairns Hospital, Cairns, QLD, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Catherine","family":"Wilkinson","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Cairns Hospital, Cairns, QLD, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Murty","family":"Mantha","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Cairns Hospital, Cairns, QLD, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2024,9,5]]},"reference":[{"key":"e_1_3_2_2_2","unstructured":"ANZDATA Registry. 44th Report Chapter 5: peritoneal dialysis. Australia and New Zealand Dialysis and Transplant Registry Adelaide SA Australia 2021. http:\/\/www.anzdata.org.au (accessed 9 February 2024)."},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1111\/1754-9485.12643"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.3747\/pdi.2013.00029"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1111\/sdi.13118"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.3747\/pdi.2018.00232"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1177\/08968608231172740"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.5301\/jva.5000439"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1111\/nep.12621"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1093\/ndt\/16.9.1893"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.mat.0000179786.01967.57"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1177\/08968608221080586"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1177\/089686088500500404"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1177\/089686089501500412"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.1177\/089686089401400114"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.1177\/11297298221127756"},{"key":"e_1_3_2_17_2","first-page":"585","article-title":"Improved results with a paramedian technique for the insertion of peritoneal dialysis catheters","volume":"161","author":"Spence P","year":"1985","unstructured":"Spence P, Matthews R, Khanna R, et al. Improved results with a paramedian technique for the insertion of peritoneal dialysis catheters. Surg Gynecol Obstet 1985; 161: 585\u2013587.","journal-title":"Surg Gynecol Obstet"},{"issue":"3","key":"e_1_3_2_18_2","first-page":"487","article-title":"A prospective randomised evaluation of chronic peritoneal dialysis catheters. Insertion site and intraperitoneal segment","volume":"36","author":"Rubin J","year":"1990","unstructured":"Rubin J, Didlake R, Raju S, et al. A prospective randomised evaluation of chronic peritoneal dialysis catheters. Insertion site and intraperitoneal segment. ASAIO Trans 1990; 36(3): 487\u2013500.","journal-title":"ASAIO Trans"},{"issue":"3","key":"e_1_3_2_19_2","first-page":"193","article-title":"Paramedian or midline approach in the insertion of a Tenckhoff catheter in patients with ambulatory continuous peritoneal dialysis. Comparative study","volume":"72","author":"Valdivia-Gomez G","year":"2004","unstructured":"Valdivia-Gomez G, Torre E. Paramedian or midline approach in the insertion of a Tenckhoff catheter in patients with ambulatory continuous peritoneal dialysis. Comparative study. Cir Cir 2004; 72(3): 193\u2013201.","journal-title":"Cir Cir"},{"key":"e_1_3_2_20_2","doi-asserted-by":"publisher","DOI":"10.3109\/00365599009180383"},{"key":"e_1_3_2_21_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2018.03.297"},{"key":"e_1_3_2_22_2","doi-asserted-by":"publisher","DOI":"10.1053\/j.ajkd.2019.05.024"},{"key":"e_1_3_2_23_2","doi-asserted-by":"publisher","DOI":"10.1111\/nep.13837"},{"key":"e_1_3_2_24_2","doi-asserted-by":"publisher","DOI":"10.3389\/fmed.2021.741312"}],"container-title":["The Journal of Vascular Access"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/11297298241277861","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/11297298241277861","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/11297298241277861","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,2]],"date-time":"2026-05-02T03:25:14Z","timestamp":1777692314000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/11297298241277861"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,9,5]]},"references-count":23,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2025,7]]}},"alternative-id":["10.1177\/11297298241277861"],"URL":"https:\/\/doi.org\/10.1177\/11297298241277861","relation":{},"ISSN":["1129-7298","1724-6032"],"issn-type":[{"value":"1129-7298","type":"print"},{"value":"1724-6032","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,9,5]]}}}