Use of the embedded peritoneal dialysis catheter: Experience and results from a North American Center

McCormick, Brendan; Brown, Pierre Antoine; Knoll, Greg; Yelle, Jean-Denis; Pagé, Denis E.; Biyani, Mohan; Lavoie, Susan

doi:10.1038/sj.ki.5001914

Cited by 36 publications

(41 citation statements)

References 22 publications

(20 reference statements)

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“…While surgical insertion of PD catheters remains the most common technique worldwide, problems in some PD centers include a lack of timely access to operating facilities, operating staff, and anesthesia services (21,22), plus additional problems when residents without sufficient experience are assigned to perform the procedure (23). Surgical insertion may also often require hospitalization.…”

Section: Discussionmentioning

confidence: 99%

A Change to Radiological Peritoneal Dialysis Catheter Insertion: Three-Month Outcomes

et al. 2010

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♦♦ ♦♦ ♦ Background: Best practices for peritoneal dialysis (PD) catheter insertion call for timely placement of catheters to reduce complications and increase the likelihood of a successful initiation of PD. The purpose of our study was to assess if a change in approach to PD catheter insertion, including a switch to radiological insertion of PD catheters and introduction of a dialysis access nurse to coordinate all patient care, was associated with more outpatient procedures and achievement of guideline-based outcomes, including timelier PD starts. ♦♦ ♦♦ ♦ Methods: We conducted a single-center retrospective chart review of all patients that had their first PD catheter inserted at our center over a 7-year period ending in 2007. ♦♦ ♦♦ ♦ Results: PD catheters were placed in 88 patients by interventional radiology and in 125 patients by surgical insertion during an earlier period. Insertion of PD catheters by interventional radiology was significantly associated with a higher rate of outpatient procedures (70% vs 32%, p < 0.0001) than surgical placement. At PD start, 82% of patients that underwent radiological insertions had an estimated glomerular filtration rate of over 8 mL/minute/ 1.73 m 2 and their mean serum albumin level was 38.2 g/L. ♦♦ ♦♦ ♦ Conclusions: The new procedure of radiological insertion of PD catheters, coordinated by a dedicated dialysis access nurse, was associated with more outpatient procedures than the earlier surgical method and allowed patients to receive a PD catheter with timing consistent with clinical practice recommendations.

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Section: Discussionmentioning

confidence: 99%

A Change to Radiological Peritoneal Dialysis Catheter Insertion: Three-Month Outcomes

et al. 2010

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“…Our center places embedded PD catheters several months before the anticipated need for PD (4). Our previously published results have shown an increase in the rate of mechanical obstruction to catheter flow among those catheters that are left buried for .5 months before use (5).…”

Section: Introductionmentioning

confidence: 99%

Fluoroscopic Manipulation of Peritoneal Dialysis Catheters

Miller

McCormick

Lavoie

et al. 2012

Clinical Journal of the American Society of Nephrology

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SummaryBackground and objectives Mechanical failure of the peritoneal dialysis (PD) catheter is an important cause of technique failure. Fluoroscopic guidewire manipulation may be undertaken in an attempt to correct the failure. The purpose of this study was to determine the efficacy of fluoroscopic manipulation of previously embedded PD catheters, the factors associated with successful manipulation, and the complication rate associated with manipulation.Design, setting, participants, & measurements A single-center, retrospective review of 70 consecutive PD patients undergoing fluoroscopic manipulation for mechanical failure of their PD catheter from June 2006 to February 2011 was undertaken. Logistic regression models were developed to determine the variables associated with successful manipulation.Results Of the 70 manipulations, 44 were successful (62.9%). In univariate analysis, catheters located in the pelvis compared with those in the upper abdomen (73.5% versus 42.9%, P=0.01) and catheters that were previously functional compared with those that failed at exteriorization (75.0% versus 46.7%, P=0.04) were more likely to be successfully manipulated. Time embedded, previous hemodialysis, and number of intra-abdominal surgeries were not correlated with likelihood of successful manipulation. In multivariate analysis, catheters located in the pelvis (P=0.01) and those with secondary failure (P=0.01) were more likely to successfully manipulated. Two of the patients developed peritonitis (2.9%), neither requiring cessation of PD.Conclusions Fluoroscopic manipulation is an effective and safe therapy for failed PD catheters that are unresponsive to conservative treatment. Properly positioned catheters and those that were previously functional are more likely to be successfully manipulated.

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“…Our published reports of over 400 buried PD catheters have shown that this technique is associated with low rates of surgical, mechanical, and infectious complications (3). Over the years, we have noted from time to time asymptomatic peritoneal leukocytosis with negative effluent cultures immediately after exteriorization of a buried catheter.…”

mentioning

confidence: 91%

“…At the Ottawa Hospital, when the patient is ready to start PD, the catheter is exteriorized by the home dialysis nephrologist at the bedside through a small incision using local anesthetic and under sterile technique. The transfer set is then attached and the patient begins PD training the same day (3). At the Toronto General, the catheter is usually exteriorized a few days to a week prior to training.…”

Section: Methodsmentioning

confidence: 99%

Asymptomatic Peritoneal Leukocytosis after Exteriorization of Buried Peritoneal Dialysis Catheters: A Case Series

et al. 2015

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Use of the embedded peritoneal dialysis catheter: Experience and results from a North American Center

Cited by 36 publications

References 22 publications

A Change to Radiological Peritoneal Dialysis Catheter Insertion: Three-Month Outcomes

A Change to Radiological Peritoneal Dialysis Catheter Insertion: Three-Month Outcomes

Fluoroscopic Manipulation of Peritoneal Dialysis Catheters

Asymptomatic Peritoneal Leukocytosis after Exteriorization of Buried Peritoneal Dialysis Catheters: A Case Series

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