Peritoneal Dialysis Access and Exit-Site Care Including Surgical Aspects

Kathuria, Pranay; Zj, Twardowski; Nichols, W. Kirt

doi:10.1007/978-0-387-78940-8_14

Cited by 16 publications

(12 citation statements)

References 244 publications

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“…We speculated that previous researchers might have accepted this hypothetical explanation as the proven fact, despite there is not enough evidence to suggest that the right‐sided upward migration cannot usually be corrected by conservative management. Indeed, we found through a detailed literature review that the success rate (25%) reported by Rubin as well as a Twardowski's hypothetical explanation have been cited in subsequent studies without proper validation …”

Section: Discussionmentioning

confidence: 96%

“…Indeed, we found through a detailed literature review that the success rate (25%) reported by Rubin 6 as well as a Twardowski's hypothetical explanation 14 have been cited in subsequent studies without proper validation. 8,[15][16][17] Overall catheter survival at 1 and 5 years of our patients was 89.2% and 68.6%, respectively. Catheter survival showed no difference between the non-migration group and the migration group.…”

Section: Discussionmentioning

confidence: 99%

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Effects of early detection of peritoneal catheter migration on clinical outcomes: 15‐years experiences from a single centre

Kim

Shin

et al. 2019

Nephrology

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Aim Catheter migration is an important cause of catheter malfunction in peritoneal dialysis (PD). The purpose of this study was to investigate the effect of early detection of catheter migration on clinical outcomes. Methods A retrospective review of 135 consecutive patients initiating PD immediately following catheter insertion from 2002 to 2017 was undertaken. In order to detect catheter migration without malfunction early, serial abdominal‐pelvic radiographic examinations were performed according to a predefined protocol. Conservative management with rigorous catharsis was undertaken to correct catheter migration. A Kaplan–Meier method was used to calculate survival rate. Results Mean follow‐up period was 42.8 ± 34.9 months. Catheter migration occurred in 62.4%. Among them, 85.9% occurred within the first 2 weeks after catheter insertion. There were no significant associations between catheter migration and variables such as gender, obesity, DM and type of catheter. Success rate of conservative management with rigorous catharsis was 91.1%. Catheter survival at 1 and 5 years were 91.5% and 64.6% in the migration group and 81.2% and 69.9% in the non‐migration group, respectively (Log–rank test, P = 0.915). Patient survival at 1 and 5 years were 96.8% and 85.8% in the migration group and 91.9% and 82.3% in the non‐migration group, respectively (P = 0.792). Conclusion Early detection of PD catheter migration allowed the migrated tip to be easily corrected with conservative management. Once the migrated catheter tip was restored, catheter migration itself did not affect catheter survival. These findings suggest that early detection and correction of catheter migration is important for improving clinical outcomes.

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Section: Discussionmentioning

confidence: 96%

Section: Discussionmentioning

confidence: 99%

Effects of early detection of peritoneal catheter migration on clinical outcomes: 15‐years experiences from a single centre

Kim

Shin

et al. 2019

Nephrology

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“…Blind placement is performed without direct visualization of the peritoneum. Tenckhoff was the first to advocate this approach of using a trocar for the insertion of the catheter 11 . This method, which requires the least equipment, is safe and it is mainly performed by nephrologists.…”

Section: Introductionmentioning

confidence: 99%

Blind peritoneal catheter placement with a tenckhoff trocar by nephrologists: A single‐center experience

et al. 2012

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“…For instance, initiation of catheter insertion by nephrologists in 3 centers in the United States was associated with a 22% -32% increase in the number of PD patients, and a return to catheter insertion by surgeons led to a decline in the PD population (10). Recently, the modified Seldinger technique (14), using a peel-away introducer sheath, seems to have reduced the incidence of bowel perforation. The technique gained popularity among nephrologists and achieved results comparable to those with laparoscopic insertion (14).…”

Section: Discussionmentioning

confidence: 99%

“…Recently, the modified Seldinger technique (14), using a peel-away introducer sheath, seems to have reduced the incidence of bowel perforation. The technique gained popularity among nephrologists and achieved results comparable to those with laparoscopic insertion (14). However, the modified Seldinger technique uses a pointed-tip introducer, and the dilators are introduced along the track created by the guidewire and not along the guidewire itself.…”

Section: Discussionmentioning

confidence: 99%

Percutaneous Peritoneal Dialysis Catheter Insertion by a Nephrologist: A New, Simple, and Safe Technique

Al-Hwiesh

2013

Peritoneal Dialysis International

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♦ Background: Insertion of the peritoneal dialysis (PD) catheter by a nephrologist has been encouraged by several studies. The ultimate goal is to provide safe, timely, and effective catheter insertion without an unduly long wait time or delay. The success of PD depends partly on the ease of catheter insertion. We developed a new technique for percutaneous PD catheter insertion by nephrologists. Our new technique, in addition to being easy, proved to be safe and to eliminate the need for the peel-away sheath. ♦ Methods: Data were collected prospectively on all patients having a PD catheter inserted by a nephrologist using our new technique (40 catheters in 38 patients). All catheters were evaluated for infectious and mechanical complications. ♦ Results: The mean duration of the procedure from skin sterilization to the end of insertion was 24 ± 3 minutes. No bowel perforation or serious hemorrhage was recorded. Poor initial drainage was recorded in 12.5% of the catheters (n = 5) during the 4 weeks after insertion. The incidence of early exit-site leakage was 2.5% (1 catheter). Episodes of exit-site infection occurred in 5.0% and 12.5% of catheters (within 1 month and by the end of study period respectively). Two episodes of peritonitis were reported by the end of the 12-month period. Catheter survival was 95.0% and 87.5% at 6 months and 12 months respectively. ♦ Conclusions: Percutaneous bedside placement of PD catheters using our new technique is safe and carries less morbidity in terms of bowel perforation, catheter-related infection, and exit-site leak. In addition, our new technique appears to have a high success rate and to offer considerable savings in terms of operating time.

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Peritoneal Dialysis Access and Exit-Site Care Including Surgical Aspects

Cited by 16 publications

References 244 publications

Effects of early detection of peritoneal catheter migration on clinical outcomes: 15‐years experiences from a single centre

Effects of early detection of peritoneal catheter migration on clinical outcomes: 15‐years experiences from a single centre

Blind peritoneal catheter placement with a tenckhoff trocar by nephrologists: A single‐center experience

Percutaneous Peritoneal Dialysis Catheter Insertion by a Nephrologist: A New, Simple, and Safe Technique

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