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Abstract: FR-PO680

Abdominal Rectus Thickening as a Predictor of Peritoneal Catheter Primary Dysfunction

Session Information

Category: Dialysis

  • 703 Dialysis: Peritoneal Dialysis

Authors

  • Maggiani, Pablo, Hospital Civil De Guadalajara, University of Guadalajara, Zapopan, JALISCO, Mexico
  • Navarro Blackaller, Guillermo, Hospital Civil De Guadalajara, University of Guadalajara, Zapopan, JALISCO, Mexico
  • Chavez, Jonathan, Hospital Civil De Guadalajara, University of Guadalajara, Zapopan, JALISCO, Mexico
  • Alcantar Vallin, Maria de la luz, Hospital Civil De Guadalajara, University of Guadalajara, Zapopan, JALISCO, Mexico
  • Garcia-Garcia, Guillermo, Hospital Civil De Guadalajara, University of Guadalajara, Zapopan, JALISCO, Mexico
  • Carreon bautista, Elsa edith, Hospital Civil De Guadalajara, University of Guadalajara, Zapopan, JALISCO, Mexico
Background

Percutaneous insertion of peritoneal dialysis (PD) catheters by nephrologists are an effective alternative to open surgical techniques. Complications following PD catheter insertion requiring manipulation or replacement are about 20%. Previous studies show that ultrasound measurements of skin depth to the peritoneum with values> 5.5 cm (p <0.001) are associated at percutaneous DP catheter dysfunction.

Methods

We conducted a cross-sectional study of 46 patients who had their first percutaneous peritoneal dialysis (PD) catheter and had a primary PD catheter dysfunction (PDC) defined as PD catheter removal when the PDC never worked due to a problem related to the catheter. They were divided into 2 groups: Group A patients who presented DPC dysfunction (20 patients) and Group B without DPC dysfunction (26 patients).

We perform ultrasound measurement of the abdominal wall to all patients after DPC was inserted. We mesured distance from the surface of the skin to the parietal peritoneum (SPP) and the thickness of the rectus abdominis (RAT) in centimeters (cm) in the sagittal plane, on the medial border of the rectus abdominus muscle at the level of the umbilicus, just above the scar of the procedure. Body mass index (BMI), central obesity (CO) was calculated.

Results

The mean age was 44.3 years (SD +/- 13.6). The BMI of Group A 24.9 kg / m2 (SD +/- 5.5) and Group B 24.4kg / m2 (SD +/- 4.1), central obesity (OC) of group A 93.6cm (SD +/- 16.8) and Group B 90.5 cm (SD +/- 11.2), SPP Group A 2.7 cm (SD +/- 0.94), Group B 2.2 cm (SD +/- 0.7), Group A RAT 1,005 cm (SD +/- 0.2), Group B 0.7cm (SD +/- 0.15).

Of the 46 patients, 43% (20) had primary PDC dysfunction (group A). The RAT > 1 cm was the only variable that was significantly associated with the primary dysfunction of the PD catheter (RR: 6.8, IC 95% 2.7-16.0) OR: 100, (IC 95% 10.23 .977.1, p <0.0001), a sensitivity of 80%, specificity 96%, PPV of 94% NPV of 86%, with an AUC 0.86.

Conclusion

It was also observed that 94.4% (17) of patients with CO who did not have primary PDC dysfunction had a RAT <1 cm. No significant association was observed between primary PDC dysfunction and other risk factors, such as age, BMI, CO and SPP. The RAT > 1cm is an very good predictor of the risk of primary dysfunction of the PD catheter.