Creating and Maintaining Optimal Peritoneal Dialysis Access in the Adult Patient: 2019 Update

Crabtree, John H.; Shrestha, Badri Man; Chow, Kai‐Ming; Figueiredo, Ana Elizabeth; Povlsen, Johan V.; Wilkie, Martin; Abdelaal, Ahmed; Cullis, Brett; Goh, Bak Leong; Briggs, Victoria; Brown, Edwina A.; Dor, Frank J. M. F.

doi:10.3747/pdi.2018.00232

Cited by 218 publications

(267 citation statements)

References 185 publications

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“…11,12 However, these published studies are underpowered. Equipoise was also noted in the most updated International Society for Peritoneal Dialysis (ISPD) guideline on PD access, 14 which recommends the use of catheters with either a straight or coiled tip.…”

Section: Methodsmentioning

confidence: 99%

Straight Versus Coiled Peritoneal Dialysis Catheters: A Randomized Controlled Trial

Chow

Wong

et al. 2020

American Journal of Kidney Diseases

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Section: Methodsmentioning

confidence: 99%

Straight Versus Coiled Peritoneal Dialysis Catheters: A Randomized Controlled Trial

Chow

Wong

et al. 2020

American Journal of Kidney Diseases

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“…The catheters were placed percutaneously or surgically by three experienced nephrologists from the PD center of Chinese PLA General Hospital who used the same operation approach. Catheter insertions were performed according to the published protocols [17][18][19]. Percutaneous insertions were performed at the bedside within 24 h to 48 h after admission.…”

Section: Patient Characteristics and Data Sourcesmentioning

confidence: 99%

“…Instead, patient death was a censoring condition of catheter survival. We defined complications occurring within 30 days (non-infectious) or within 2 weeks (infectious) after catheter insertion as early complications, otherwise described as late [19,20]. The non-infectious complications consisted of mechanical catheter dysfunction, leakage, hernia development, bleeding, visceral injury and insertion failure.…”

Section: Outcomes and Definitionsmentioning

confidence: 99%

Percutaneous insertion of peritoneal dialysis catheter is a safe and effective technique irrespective of BMI

Xie¹,

Zhou

Cao

et al. 2020

BMC Nephrol

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Background: A large body mass index (BMI) has been considered as a relative contraindication for percutaneous catheter insertion, although this technique has many advantages. Up to now, there are few studies on peritoneal catheter placement and obesity. The aim of this study was to determine whether patients with large BMI can also choose the percutaneous technique for peritoneal dialysis catheter insertion. Methods: One hundred eighty seven consecutive patients underwent peritoneal catheter insertions in the Chinese PLA General Hospital between January 1, 2015 and December 31, 2016, with 178 eligible cases being included in the analysis. Two groups were created based on the catheter insertion techniques, the percutaneous group (group P) and the surgical group (group S). Subgroups were created according to BMI > 28 or ≤ 28. The outcomes included catheter related complications and catheter survival. Results: Total infectious complication rates were significantly lower in group P than in group S. There were no significant differences in peritonitis rate between group P and group S (1.20% vs. 3.16% with P = 0.71 in early stage, and 4.82% vs. 11.58% with P = 0.11 in late stage). All other measured complications were similar between the two groups. Though the one-year infection-free catheter survival in group P was 7.5% higher than group S, the difference was not significant. The one-year dysfunction-free catheter survival, one-year dysfunction-and-infectionfree catheter survival, and overall catheter survival were similar between the two groups. Subgroup analyses showed a superior one-year infection-free catheter survival of percutaneous technique in patients with BMI > 28, which was confirmed by Kaplan-Meier analysis. Conclusions: Despite the challenges that may be encountered with patients who have a large BMI, the percutaneous technique seems to be a safe and effective approach to placing a peritoneal dialysis catheter.

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“…No test device migrated, as depicted on biplane radiographic imaging, peritoneography, and axial cone beam CT scanning, despite lling the peritoneum with saline and provocative maneuvering (360-degree rolls of the cadavers for each test device).(Figs. [3][4][5][6] Saline ow rates for each test device and cadaver are shown in Table 2. All in-ow and out-ow rates (total volume within 10 min) and volumes (greater than 0.7L in or out) were acceptable, except for a low volume of 0.2L drained out of the Merit catheter with no device after the roll in cadaver 1, low volume of 0.6L out of the Covidien catheter with an 8 cm straight device prior to the roll in cadaver 2, and a low volume of 0.5L out of the Merit catheter with an 8 cm straight device prior to the roll in cadaver 3.…”

Section: Cadaver Studymentioning

confidence: 99%

Pre-clinical Evaluation of a Variable Length and Conforming Peritoneal Dialysis Catheter Weighted Anchor: In Vitro Analysis and Cadaver Feasibility Study

Morris

Johnston

DeSarno

et al. 2020

Preprint

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Purpose Peritoneal dialysis (PD) catheters function best when residing within the retrovesical space of the peritoneal cavity, but they frequently migrate and fail. A novel variable length and conforming PD catheter weighted anchor to prevent migration has been evaluated.Methods Test devices were placed in normal saline for 21 months. The effluent was periodically measured for heavy metals, including tungsten. The water-tight property of the device was also tested separately. Four cadavers were subjected to three-dimensional imaging and maneuvering to evaluate percutaneous insertion, function, stability within the retrovesical space, and percutaneous retrievability in 10 test devices.Results Liquid leakage was low, with a mean absorbance of the test device effluent saline of 0.015. Mean methylene blue absorbance of the test device was significantly lower than the positive control (p-value = 0.01). Leakage of tungsten from devices made with medical grade Silastic tubing was also low, with a mean of 0.362 mg/L in the effluent saline, compared to a background concentration of 0.166 mg/L. Each test device was successfully inserted into the retrovesical space and retrieved percutaneously and remained completely intact following placement and insertion. No test device migrated as shown on axial cone beam CT imaging. Mean flow times and volumes were satisfactory at 3 minutes and 0.92L, respectively, for all test devices. For all catheters, the mean flow rate was 312 cc/min. No significant difference was found between the pre-roll and post-roll mean flow rates of the test devices (p-value = 0.35).Conclusion This PD catheter weighted anchor showed stability, with minimal leakage of tungsten. All test devices were successfully inserted and retrieved percutaneously, with no damage or migration, and mean flow rates were satisfactory. Further investigation is warranted.

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Creating and Maintaining Optimal Peritoneal Dialysis Access in the Adult Patient: 2019 Update

Cited by 218 publications

References 185 publications

Straight Versus Coiled Peritoneal Dialysis Catheters: A Randomized Controlled Trial

Straight Versus Coiled Peritoneal Dialysis Catheters: A Randomized Controlled Trial

Percutaneous insertion of peritoneal dialysis catheter is a safe and effective technique irrespective of BMI

Pre-clinical Evaluation of a Variable Length and Conforming Peritoneal Dialysis Catheter Weighted Anchor: In Vitro Analysis and Cadaver Feasibility Study

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