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Abstract: FR-PO673

Clinical Outcomes Associated with Peritoneal Dialysis Catheter Placement by Interventional Radiology

Session Information

Category: Dialysis

  • 703 Dialysis: Peritoneal Dialysis

Authors

  • Côté, Gabrielle, Université Laval, Québec, Quebec, Canada
  • Begin, Yannick, Université Laval, Québec, Quebec, Canada
  • Rousseau-Gagnon, Mathieu, CHU de Quebec, Hotel-Dieu de Quebec Hospital, Quebec, Quebec, Canada
  • Agharazii, Mohsen, CHU de Quebec, Hotel-Dieu de Quebec Hospital, Quebec, Quebec, Canada
  • Mac-Way, Fabrice, CHU de Quebec, Hotel-Dieu de Quebec Hospital, Quebec, Quebec, Canada
Background

Fluoroscopy-guided peritoneal dialysis (PD) catheter insertion by interventional radiologist (IR) has been reported as an appropriate alternative to surgical insertion to increase access to PD. The objective of this study was to report clinical outcomes and complications associated with PD catheter insertion by IR.

Methods

We conducted a single-center retrospective study of all patients who had PD catheter insertion by IR from January 2014 to January 2018. The primary outcomes were to report the complications related to catheter insertion within the first 3 months and the number of active PD patients at 3 months. Secondary outcomes were to evaluate the impact on the prevalent number of PD patients and on the waiting time for PD catheter insertion.

Results

56 patients with a median age of 55 years old (20-85) were included in this study. Patients with severe obesity (IMC>35), polycystic kidney disease and previous major surgery were not eligible for IR and were referred for laparoscopic insertion. Among these 56 patients, 1 had kidney transplantation, 1 had renal recovery and 2 were deemed unable to learn the procedure. Therefore, 52 completed the training and began PD. Among these 52 patients, 49 (94%) were on active PD at 3 months (catheter removed due to an acute intestinal perforation post-insertion (n=1), refractory peritonitis (n=1) and a pleural leak (n=1)). Within 3 months, catheter malposition occurred in 12 (21%) patients but only 3 of them needed surgical or IR repositioning. Three patients (5%) experienced peri-catheter leaks where PD was successfully restarted after temporary cessation for 4 weeks. Finally, 1 patient developed peritonitis and 1 had exit site infection that were successfully treated with antibiotics. Since the introduction of this technique, the number of prevalent PD patients in our center increased from 60 to 84 while the average time for PD catheter insertion has decreased from 4.5 to 1.5 months.

Conclusion

Insertion of PD catheter by IR is associated with a low complication rate while it improves access to PD therapy. Its use should therefore be encouraged as an alternative to surgical placement in most patients.