A prospective randomized evaluation of chronic peritoneal catheters. Insertion site and intraperitoneal segment. The insertion site (midline or through the lateral rectus muscle) and type of chronic dialysis catheter (straight or spiral intraperitoneal segment) were evaluated in a prospective randomized trial. Dialysis catheter complications and catheter survival were the endpoints of evaluation. Eighty-five first catheters were evaluated. Neither race, gender, renal diagnosis, type of catheter, nor insertion site was a determinant of dialysis catheter survival. Overall median catheter survival was 308 days. There were 40 catheter complications (70%, n = 28) that occurred during the first 61 days following insertion. Median time to the first complication occurring within the first 61 days was 3 days. Late catheter removals were due to peritonitis episodes that failed to resolve. Complications are frequent with peritoneal dialysis catheters, and care of the peritoneal dialysis catheters requires constant vigilance. 