Randomized Controlled Trials for Comparison of Laparoscopic Versus Conventional Open Catheter Placement in Peritoneal Dialysis Patients: A Meta-Analysis

Sun, Mei-lan; Wang, Bo; Zhang, Haining; Zhang, Yong

doi:10.21203/rs.2.12772/v2

Cited by 2 publications

(2 citation statements)

References 17 publications

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“…15 Still, previous studies have not yielded results that could lead to recommendations for the preferred use of a catheter delivery technique or specific PD catheter type. 34,35 The workgroup PD catheter access of PDOPPS hypothesises that standardised protocols for catheter insertion will be associated with a reduction of technique failure, the results of this working group are thus eagerly awaited. 15 A possible other reduction in technique failure might be the increased interest in assisted PD due to the ageing dialysis population.…”

Section: Discussionmentioning

confidence: 99%

Technique failure in peritoneal dialysis: Modifiable causes and patient-specific risk factors

et al. 2022

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Background: Technique survival is a core outcome for peritoneal dialysis (PD), according to Standardized Outcomes in Nephrology-Peritoneal Dialysis. This study aimed to identify modifiable causes and risk factors of technique failure in a large Dutch cohort using standardised definitions. Methods: Patients who participated in the retrospective Dutch nOcturnal and hoME dialysis Study To Improve Clinical Outcomes cohort study and started PD between 2012 and 2016 were included and followed until 1 January 2017. The primary outcome was technique failure, defined as transfer to in-centre haemodialysis for ≥ 30 days or death. Death-censored technique failure was analysed as secondary outcome. Cox regression models and competing risk models were used to assess the association between potential risk factors and technique failure. Results: A total of 695 patients were included, of whom 318 experienced technique failure during follow-up. Technique failure rate in the first year was 29%, while the death-censored technique failure rate was 23%. Infections were the most common modifiable cause for technique failure, accounting for 20% of all causes during the entire follow-up. Leakage and catheter problems were important causes within the first 6 months of PD treatment (both accounting for 15%). APD use was associated with a lower risk of technique failure (hazard ratio 0.66, 95% confidence interval 0.53–0.83). Conclusion: Infections, leakage and catheter problems were important modifiable causes for technique failure. As the first-year death-censored technique failure rate remains high, future studies should focus on infection prevention and catheter access to improve technique survival.

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Section: Discussionmentioning

confidence: 99%

Technique failure in peritoneal dialysis: Modifiable causes and patient-specific risk factors

et al. 2022

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“…There are various established modalities of insertion of PD catheters, including both percutaneous and surgical approaches [14]. Laparoscopy-assisted placement is standard of care in our surgical practice and broadly in the USA, with catheter insertion by open surgical dissection being less commonly performed today.…”

Section: Introductionmentioning

confidence: 99%

Safety and Efficacy of Bedside Peritoneal Dialysis Catheter Placement in the COVID‐19 Era: Initial Experience at a New York City Hospital

2020

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Introduction Acute kidney injury (AKI) requiring renal replacement therapy (RRT) is common in critically ill patients with COVID-19. Unparalleled numbers of patients with AKI and shortage of dialysis machines and operative resources prompted consideration of expanded use of urgent-start peritoneal dialysis (PD) and evaluation of the safety and efficacy of bedside surgical placement of PD catheters. Study design Bedside, open PD catheter insertions were performed in early April 2020, at a large academic center in New York City. Patients with SARS-CoV-2 infection and AKI and ambulatory patients with chronic kidney disease and impending need for RRT were included. Detailed surgical technique is described. Results Fourteen catheters were placed at the bedside over 2 weeks, 11 in critically ill COVID-19 patients and three in ambulatory patients. Mean patient age was 61.9 years (43-83), and mean body mass index was 27.1 (20-37.6); four patients had prior abdominal surgery. All catheters were placed successfully without routine radiographic studies or intraoperative complications. One patient (7%) experienced primary nonfunction of the catheter requiring HD. One patient had limited intraperitoneal bleeding while anticoagulated, which was managed by mechanical compression of the abdominal wall and temporarily holding anticoagulation. All other catheters had an adequate function at 3-18 days of follow-up. Conclusions Bedside placement of PD catheters is safe and effective in ICU and outpatient clinic settings. Our surgical protocols allowed for optimization of critical hospital resources, minimization of hazardous exposure to healthcare providers and a broader application of urgent-start PD in selected patients. Long-term follow-up is warranted.

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Randomized Controlled Trials for Comparison of Laparoscopic Versus Conventional Open Catheter Placement in Peritoneal Dialysis Patients: A Meta-Analysis

Cited by 2 publications

References 17 publications

Technique failure in peritoneal dialysis: Modifiable causes and patient-specific risk factors

Technique failure in peritoneal dialysis: Modifiable causes and patient-specific risk factors

Safety and Efficacy of Bedside Peritoneal Dialysis Catheter Placement in the COVID‐19 Era: Initial Experience at a New York City Hospital

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