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CC BY-NC-ND 4.0 · The Arab Journal of Interventional Radiology 2022; 06(02): 082-086
DOI: 10.1055/s-0042-1758040
Original Article

Outcomes of Percutaneous Peritoneal Dialysis Catheters Insertion by Interventional Radiologists: A Single-Institution Experience

Khadijah Alhussaini
1   Vascular Interventional Radiology Section, Medical Imaging Department, King Abdulaziz Medical City, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia
,
Shaima Abulqasim 
1   Vascular Interventional Radiology Section, Medical Imaging Department, King Abdulaziz Medical City, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia
,
Abdulaziz Mohammad Al-Sharydah
2   Diagnostic and Interventional Radiology Department, Imam Abdulrahman Bin Faisal University, King Fahd Hospital of the University, Khobar City, Eastern Province, Saudi Arabia
,
Elwaleed Elhassan 
3   Nephrology Section, Department of Internal Medicine, King Abdulaziz Medical City, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia
,
Mohammad Arabi 
1   Vascular Interventional Radiology Section, Medical Imaging Department, King Abdulaziz Medical City, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia
› Institutsangaben Funding This study did not receive any specific grant from funding agencies in the public, commercial, and not-for-profit sectors.
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Abstract

Objectives This article evaluates the short- and long-term outcomes of percutaneous peritoneal dialysis (PD) catheters inserted by interventional radiology service and analyzes the factors that affect the sustainability of patent and functional PD catheters.

Materials and Methods Retrospective single-institution study between April 2015 and February 2021. A total of 131 patients (75 males) were enrolled with mean age of 50 ± 19.6 years with an average body mass index (BMI) of 28 ± 7 kg/m2. Technical and clinical success were evaluated. Catheter-related complications were classified into mechanical and nonmechanical categories, including infectious complications. Indications for removal were analyzed.

Results Technical and clinical success were 100%. The average dwelling time for the entire cohort was 497.5 ± 462.3 days. Forty-six patients (35%) were on PD at the last follow-up with an average dwelling time of 492 days. PD-related complications were reported in 79/131 (60.3%) patients, including peritonitis (40.46%; 53/131), followed by malposition/migration (12.21%; 16/131), tunnel/exit site infection (10.69%; 14/131), and dysfunction (12.21%; 16/131). The incidence of peritonitis within 30 days postinsertion was 9.43% (5/53). The average interval between insertion and migration was 100.5 ± 144.8 days (95% confidence interval, 6.9–14.4). There was a trend for a higher rate of malposition/migration in patients with higher BMI (p = 0.0561). Causes for PD catheters removal were: (1) infection-related (24.4%; 32/131), (2) renal transplant recipients (16%; 21/131), (3) mechanical complications (13.7%; 18/131), and (4) patient's preference (7.6%; 10/131).

Conclusion Percutaneous PD catheter placement by interventional radiologists provides acceptable long-term outcomes and complication rates that meet the recommended standards.

Keywords

interventional radiology - image-guided interventions - percutaneous catheter insertion - peritoneal dialysis catheter - peritoneal dialysis

Ethical Approval and Consent to Participate

The article, in its entirety and detail, does not include disclosing the identity of individuals or information indicating them. This medical/educational report is intended to develop or contribute to generalizable knowledge and does not represent the development, testing. Given the purely descriptive and retrospective nature of the study, and in compliance with the Helsinki Declaration, informed consent was waived.


Availability of Data and Materials

The principal investigator is responsible for sharing the study-related data publicly upon reasonable request from the publishing journal.


Authors' Contributions

All authors conducted all aspects of this study and agree to be accountable for all aspects of the work that has been reported in the article.




Publikationsverlauf

Artikel online veröffentlicht:
14. November 2022

© 2022. The Pan Arab Interventional Radiology Society. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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  • References

  • 1 Oza-Gajera BP, Abdel-Aal AK, Almehmi A. eds. Complications of Percutaneous Peritoneal Dialysis Catheter. InSeminars in Interventional Radiology 2022 Feb (Vol. 39, No. 01, pp. 040–046). Thieme Medical Publishers, Inc.; DOI: 10.1055/s-0041-1741484
    Artikel in Thieme ConnectGoogle Scholar
  • 2 Al Attar B. Renal replacement therapy in the Kingdom of Saudi Arabia. Saudi J Kidney Dis Transpl 2021; 32 (04) 1188-1200
    CrossrefPubMedGoogle Scholar
  • 3 Khudari HE, Abdel-Aal AK, Abaza M, Almehmi SE, Sachdeva B, Almehmi A. Peritoneal Dialysis Catheter Placement: Percutaneous and Peritoneoscopic Techniques. Semin Intervent Radiol 2022; 39 (01) 23-31
    Artikel in Thieme ConnectPubMedGoogle Scholar
  • 4 Crabtree JH, Hathaway PB. eds. Patient Selection and Planning for Image-Guided Peritoneal Dialysis Catheter Placement. InSeminars in Interventional Radiology 2022 Feb (Vol. 39, No. 01, pp. 032-039). Thieme Medical Publishers, Inc.;
    Artikel in Thieme ConnectGoogle Scholar
  • 5 Chui BK, Manns B, Pannu N. et al. Health care costs of peritoneal dialysis technique failure and dialysis modality switching. Am J Kidney Dis 2013; 61 (01) 104-111
    CrossrefPubMedGoogle Scholar
  • 6 Mehrotra R, Devuyst O, Davies SJ, Johnson DW. The current state of peritoneal dialysis. J Am Soc Nephrol 2016; 27 (11) 3238-3252
    CrossrefPubMedGoogle Scholar
  • 7 Crabtree JH, Chow KM. Peritoneal dialysis catheter insertion. Semin Nephrol 2017; 37 (01) 17-29
    CrossrefPubMedGoogle Scholar
  • 8 Abdel-Aal AK, Dybbro P, Hathaway P, Guest S, Neuwirth M, Krishnamurthy V. Best practices consensus protocol for peritoneal dialysis catheter placement by interventional radiologists. Perit Dial Int 2014; 34 (05) 481-493
    CrossrefPubMedGoogle Scholar
  • 9 Singh N, Davidson I, Minhajuddin A, Gieser S, Nurenberg M, Saxena R. Risk factors associated with peritoneal dialysis catheter survival: a 9-year single-center study in 315 patients. J Vasc Access 2010; 11 (04) 316-322
    CrossrefPubMedGoogle Scholar
  • 10 Arabi M, Alammari S, Qazi S. et al. How i do it: percutaneous image-guided peritoneal dialysis catheter insertion. The Arab Journal of Interventional Radiology. 2017; 1 (02) 49-54
    Artikel in Thieme ConnectGoogle Scholar
  • 11 Crabtree JH, Shrestha BM, Chow K-M. et al. Creating and maintaining optimal peritoneal dialysis access in the adult patient: 2019 update. Perit Dial Int 2019; 39 (05) 414-436
    CrossrefPubMedGoogle Scholar
  • 12 Xie D, Zhou J, Cao X. et al. Percutaneous insertion of peritoneal dialysis catheter is a safe and effective technique irrespective of BMI. BMC Nephrol 2020; 21 (01) 199
    CrossrefPubMedGoogle Scholar
  • 13 Krezalek MA, Bonamici N, Kuchta K. et al. Peritoneal dialysis catheter function and survival are not adversely affected by obesity regardless of the operative technique used. Surg Endosc 2018; 32 (04) 1714-1723
    CrossrefPubMedGoogle Scholar
  • 14 Sayer M, Thiel C, Schenk M. et al. Intraperitoneal extension of the peritoneal dialysis catheter-a new technique for catheter implantation in patients with obesity. J Nephrol 2022; 35 (01) 311-316
    CrossrefPubMedGoogle Scholar
  • 15 Kramer HJ, Saranathan A, Luke A. et al. Increasing body mass index and obesity in the incident ESRD population. J Am Soc Nephrol 2006; 17 (05) 1453-1459
    CrossrefPubMedGoogle Scholar
  • 16 Voss D, Hawkins S, Poole G, Marshall M. Radiological versus surgical implantation of first catheter for peritoneal dialysis: a randomized non-inferiority trial. Nephrol Dial Transplant 2012; 27 (11) 4196-4204
    CrossrefPubMedGoogle Scholar
  • 17 De Boo DW, Mott N, Tregaskis P. et al. Percutaneous insertion of peritoneal dialysis catheters using ultrasound and fluoroscopic guidance: a single centre experience and review of literature. J Med Imaging Radiat Oncol 2015; 59 (06) 662-667
    CrossrefPubMedGoogle Scholar
  • 18 Maher E, Wolley MJ, Abbas SA, Hawkins SP, Marshall MR. Fluoroscopic versus laparoscopic implantation of peritoneal dialysis catheters: a retrospective cohort study. J Vasc Interv Radiol 2014; 25 (06) 895-903
    CrossrefPubMedGoogle Scholar
  • 19 Hagen SM, Lafranca JA, IJzermans JN, Dor FJ. A systematic review and meta-analysis of the influence of peritoneal dialysis catheter type on complication rate and catheter survival. Kidney Int 2014; 85 (04) 920-932
    CrossrefPubMedGoogle Scholar
  • 20 Gokal R, Alexander S, Ash S. et al. Peritoneal catheters and exit-site practices toward optimum peritoneal access: 1998 update. (Official report from the International Society for Peritoneal Dialysis). Perit Dial Int 1998; 18 (01) 11-33
    CrossrefPubMedGoogle Scholar
  • 21 Agarwal A, Whitlock RH, Bamforth RJ. et al. Percutaneous versus surgical insertion of peritoneal dialysis catheters: a systematic review and meta-analysis. Can J Kidney Health Dis 2021; 8: 20 543581211052731
    CrossrefPubMedGoogle Scholar