PD Catheter Survival: Modified Percutaneous vs Moncrief-Popovich

Catheter Survival and Functionality of Peritoneal Dialysis Catheters Placed by Conventional Modified Percutaneous Technique Versus Moncrief-Popovich Technique in Adults With Chronic Kidney Disease

Peritoneal dialysis (PD) catheter placement technique may affect catheter survival, functionality and infection risk. The Moncrief-Popovich (subcutaneous burying or embedding) technique was developed to reduce exit-site/tunnel infections during the interval between insertion and first use.

Objective: Compare PD catheter survival, functionality and complication rates between conventional modified percutaneous placement and Moncrief-Popovich in adults initiating planned PD.

Brief methods: Prospective, randomized, parallel-arm study enrolling adult CKD patients scheduled for planned PD initiation and catheter placement at Hospital Civil de Guadalajara between Jan 2024 and Dec 2025. Patients randomized 1:1 to conventional modified percutaneous placement group or Moncrief-Popovich buried catheter group. Primary outcome is catheter survival/functionality during follow-up. Secondary outcomes include infectious and mechanical complications, peritonitis incidence, and need to change dialysis modality.

Study Overview

• Status: Active, not recruiting
• Conditions: Chronic Kidney Disease (CKD) Stage 5; Peritoneal Dialysis Access
• Intervention / Treatment: Procedure: Modified Percutaneous PD catheter placement; Procedure: Embedded Peritoneal catheter placement

Detailed Description

This prospective, randomized, comparative longitudinal study evaluates PD catheter survival and functionality in adult patients with advanced chronic kidney disease undergoing planned PD catheter placement at Hospital Civil de Guadalajara "Fray Antonio Alcalde" from January 2024 to December 2025. Eligible patients are randomized 1:1 to receive either the conventional modified percutaneous catheter placement (Group A) or the Moncrief-Popovich technique with subcutaneous burial of the distal catheter segment until exteriorization (Group B). Data are collected from medical records and nephrology clinic follow-up visits. Outcomes include catheter survival time, functional status at baseline and during follow-up, early and late infectious (exit-site infection, tunnel infection, peritonitis) and mechanical complications, and requirement for dialysis modality change due to catheter failure. Statistical analyses compare rates and time-to-event outcomes between groups; significance set at p < 0.05. Study procedures comply with institutional ethics oversight and informed consent requirements.

• Study Type: Interventional
• Enrollment (Estimated): 60
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Mexico
  • Jalisco
    • Guadalajara, Jalisco, Mexico, 44280
      • Hospital Civil de Guadalajara "Fray Antonio Alcalde"

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

• Diagnosis of chronic kidney disease requiring initiation of renal replacement therapy with planned peritoneal dialysis.
• Candidate for PD catheter placement by percutaneous techniques (either conventional modified percutaneous or Moncrief-Popovich).
• Provide informed consent and available for clinical follow-up.

Exclusion Criteria:

• Recent major abdominal surgery
• Active abdominal infections at the time of catheter placement
• Anatomical contraindications to peritoneal dialysis
• Requiring urgent start of PD (uremic syndrome, sever hyperkalemia, severe metabolic acidosis, negligible residual renal function, severe hypervolemia or acute pulmonary edema)

Elimination Criteria:

• Withdrawal of informed consent
• Loss to follow-up
• Non-catheter-related events necessitating suspension of PD that preclude further study participation

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: None (Open Label)

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Active Comparator: CONVENTIONAL MODIFIED PERCUTANEOUS PLACEMENT; Conventional Modified Percutaneous Placement: Description: Peritoneal dialysis catheter placed at bedside using the center's conventional modified percutaneous technique (nephrologist-performed), catheter externalized and tunneled per standard protocol; catheter used following standard healing period and center procedures.	Procedure: Modified Percutaneous PD catheter placement; Peritoneal dialysis catheter placed at bedside using conventional modified percutaneous technique, catheter tunneled and externalized per standard protocol; catheter used following standard healing period and center procedures performed by nephrologist.
Experimental: MONCRIEF-POPOVICH TECHNIQUE; Peritoneal dialysis catheter placed with subcutaneous burial or embedding of the external catheter segment (Moncrief-Popovich technique). Catheter remains embedded until planned exteriorization and initiation of dialysis per protocol; exteriorization performed for PD initiation.	Procedure: Embedded Peritoneal catheter placement; Peritoneal dialysis catheter placement using Moncrief-Popovich Technique performed by nephrologist

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
PD catheter survival and functionality	Functionality assessed by ability to perform adequate PD exchanges and absence of mechanical obstruction to the end of follow-up	12 months

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Peritonitis incidence	Number and rate of PD-related peritonitis episodes during follow-up	12 months
Early infectious complications	Incidence of exit-site infection or tunnel infection within 30 days after insertion	30 days
Change of dialysis modality due to catheter failure	Proportion of patients requiring modality change to hemodialysis secondary to catheter-related issues	12 months
Late infectious complications	Incidence of exit-site infection, tunnel infection beyond 30 days	12 months
Adverse events related to placement procedure	Incidence of catheter migration, obstruction, leak, malfunction, bleeding, visceral injury, requiring intervention	2 weeks

Collaborators and Investigators

• Sponsor: Hospital Civil de Guadalajara

Study record dates

Study Major Dates

• Study Start (Actual): January 1, 2024
• Primary Completion (Actual): December 31, 2025
• Study Completion (Estimated): June 1, 2026

Study Registration Dates

• First Submitted: March 6, 2026
• First Submitted That Met QC Criteria: March 6, 2026
• First Posted (Actual): March 12, 2026

Study Record Updates

• Last Update Posted (Actual): March 12, 2026
• Last Update Submitted That Met QC Criteria: March 6, 2026
• Last Verified: February 1, 2026

More Information

Terms related to this study

• Keywords: Chronic kidney disease; Peritoneal Dialysis; Moncrief; Peritoneal catheter placement
• Additional Relevant MeSH Terms: Urogenital Diseases; Pathologic Processes; Male Urogenital Diseases; Kidney Diseases; Urologic Diseases; Female Urogenital Diseases; Female Urogenital Diseases and Pregnancy Complications; Chronic Disease; Disease Attributes; Renal Insufficiency; Pathological Conditions, Signs and Symptoms; Renal Insufficiency, Chronic
• Other Study ID Numbers: CEI 128/24

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No