After kidney failure, or renal failure, doctors use a process called peritoneal dialysis to filter blood without pumping it outside of the body. A tube known as a Tenckhoff catheter introduces fluids into the body, and allows the body to exchange waste from the blood through a layer in the abdomen called the peritoneum. The catheter itself is a tube that is run into the abdominal cavity, and is permanently held in place by two cuffs. This type of catheter provides many benefits, but also carries a number of risks and drawbacks.
The body itself performs the filtration in peritoneal dialysis, and the Tenckhoff catheter simply introduces or drains fluids from the body as needed. Consequently, this form of dialysis is much less expensive than hemodialysis, which filters the blood outside of the body. Hemodialysis requires frequent doctor visits and the use of expensive equipment, so it cannot be used in many parts of the world.
Catheters such as these have the advantage of making dialysis affordable and accessible for many people. They can even relieve fluid buildup resulting from other diseases. Conditions like some mesotheliomas can cause fluid accumulation that are difficult to relieve with diuretics or shunts. Tenckhoff catheters can easily drain this fluid. Peritoneal dialysis is about as effective as hemodialysis, as well.
Some risks are inherent with the Tenckhoff catheter. They are largely related to the nature of its installation. Uncomfortable surgery is required to place the catheter in a patient. After surgery, the body creates fibrous growths to hold the catheter cuffs in place and form a seal around it. Until that time, however, patients are at risk of site infections from bacteria entering tissue from outside.
Another con of the Tenckhoff catheter is related to its removal. The catheter is kept in the body through tissue growth. Surgery is usually required to take it out, and is generally more intensive than the initial installation surgery. Recovery time from the removal surgery can actually take up several days, and uses hospital resources and beds.
Several risks are present with the Tenckhoff catheter removal surgery. It requires complete anesthesia, putting the patient in potential danger from that process. Recovery from surgery can be quite painful, and leaves significant amounts of scar tissue. There is also an increased risk of site infection from having exposed tissue during the healing process. Some alternatives to this surgery exist, but they are rarely used, so removal poses a major drawback for these catheters.
