Journal Information
Vol. 32. Issue. 5.September 2012
Pages 555-701
Vol. 32. Issue. 5.September 2012
Pages 555-701
DOI: 10.3265/Nefrologia.pre2012.Jul.11497
Full text access
Catheterography: a simple technique for the diagnosis of poor peritoneal dialysis catheter functioning
Cateterografía: técnica sencilla para el diagnóstico del mal funcionamiento del catéter de diálisis peritoneal
Isabel García-Méndeza, Sebastián Remollob, David Hernándezb, Nadia Martín-Alemanya, Jordi Calabia-Martíneza, Pere Torguet-Escudera, Gerard Maté-Benitoa, Martí Vallès-Pratsa
a Unidad de Nefrolog??a, Hospital Universitario Dr. Josep Trueta, Girona
b Servicio de Radiodiagn??stico, Hospital Universitario Dr. Josep Trueta, Girona
Article information
Full Text
Download PDF
Figures (3)
Show moreShow less
Full Text



One of the most common complications in peritoneal dialysis (PD) is poor catheter functioning, which obviously determines the dialysis treatment.

The manifestations of this condition tend to be quite clear: the PD fluid enters and/or exits only with difficulty.

The primary causes of poor catheter functioning include fibrin clot obstruction, catheter tip displacement, and bowel or omental entrapment.

Currently, we have no easily performed imaging tests that can aid in diagnosing the mechanical issues derived from poor catheter functioning. One very simple technique with high value is catheterography. This procedure was first described in the 1990s, but it is used quite infrequently, probably due to the issues of accessibility to radiological rooms.

In our hospital, this procedure has been used for approximately 2 years, thanks to the cooperation of the radiology department. We present below our experience with the technique.




The procedure takes place in the interventional radiology unit, with the assistance of a radiologist, a nephrologist, and a nurse.

With the patient lying down, the catheter is cleaned with approximately 20ml of saline solution and then 10ml of iodated contrast is infused, under aseptic conditions as always. During the contrast infusion, serial images are digitally recorded, allowing for visualisation of the position of the catheter and of its permeability. The view can be projected in several different formats (antero-posterior, oblique, lateral, etc.).

Whenever necessary, a guide through the catheter can be introduced and relocation can be attempted under direct visual control. In entrapped catheters, this operation is impossible, which indirectly also informs us as to the situation of the catheter.

Once this process is finalised, the catheter is cleaned again and, once back in the peritoneal dialysis unit, intraperitoneal antibiotics are administered as a prophylaxis, and catheter functioning is checked. The patient may return home after the test.




Case 1. 56-year-old; 4 months on CAPD without issues. Episode of severe peritonitis due to an anaerobic bacterial infection. Once recovered, the patient was started on APD. After several weeks, the patient complains of not being able to sleep due to multiple alarms. The treatment regime is evaluated, and a major drainage difficulty is revealed. A simple abdominal x-ray reveals no important findings; the tip of the catheter is observed in the pelvis. A catheterography is administered, which reveals a large loop in the catheter. The situation is resolved through the use of a guide and increased laxative treatment (Figure 1).

Case 2. 65-year-old woman who started PD after a second transplant. During surgery for the catheter placement, multiple intestinal adherences are freed. From the start, infusion went without difficulty, but drainage was impossible. A catheterography confirmed the suspicion of entrapment; the catheter was then removed through surgery (Figure 2).

Case 3. 72-year-old patient, who after 15 months on APD started to have issues with drainage, despite laxative use. The catheter tip was found in the epigastrium, and was relocated using a guide (Figure 3).

In our experience, we have not encountered any type of complication: no perforations, haemorrhages, or infections have been produced.




Catheterography is a safe, easy, and non-invasive method of substantial utility in the differential diagnosis of poor catheter functioning. It can be repeated as many times as necessary, since it presents no risk to the patient.


Conflicts of interest


The authors have no conflicts of interest to declare.

Figure 1. Case 1

Figure 2. Case 2

Figure 3. Case 3

Montenegro J,??Correa-Rotter R,??Riella M. Tratado de di??lisis peritoneal.??Elsevier; 2009.
2.??Moreiras M,??Cuina M,??Coyanes GR,??Sobrado JA,??Gonz??lez L. Mechanical complications in chronic ambulatory peritoneal di??lisis catheter placement. Clin Nephrol 1999;52(2):124-30. [Pubmed]
Xie JY, Ren H, Kiryluk K, Chen N. Peritoneal dialysis outflow failure from omental wrapping diagnosed by catheterography. Am J Kidney Dis 2010;56(5):1006-11. [Pubmed]
Scabardi M, Ronco C, Chiaramonte S, Feriani M, Agostini F, La Greca G.??Dynamic catheterography in the early diagnosis of peritoneal catheter malfunction. Int J Artif Organs 1992;15(6):358-64. [Pubmed]
Calvo Blanco J, Men??ndez de Llano R. Peritoneograf??a por TAC: t??cnica, indicaci??n y complicaci??n de la di??lisis peritoneal. 30.?? Congreso SERAM. Hospital Central de Asturias.
Stuart S, Booth TC, Cash CJ. Complications of continous ambulatory peritoneal dialysis. Radiographics 2009;29(2):441-60. [Pubmed]
Cakir B, Kirbas I, Cevik B. Complications of CAPD: evaluation with CT. Diagn Interv Radiol 2008;14(4):2012-20.
Nefrología (English Edition)

Subscribe to our newsletter

Article options
es en

¿Es usted profesional sanitario apto para prescribir o dispensar medicamentos?

Are you a health professional able to prescribe or dispense drugs?

es en
Política de cookies Cookies policy
Utilizamos cookies propias y de terceros para mejorar nuestros servicios y mostrarle publicidad relacionada con sus preferencias mediante el análisis de sus hábitos de navegación. Si continua navegando, consideramos que acepta su uso. Puede cambiar la configuración u obtener más información aquí. To improve our services and products, we use "cookies" (own or third parties authorized) to show advertising related to client preferences through the analyses of navigation customer behavior. Continuing navigation will be considered as acceptance of this use. You can change the settings or obtain more information by clicking here.