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Abstract: PO1303

Omentectomy Reduces the Need for Peritoneal Dialysis Catheter Revision in Children: A Study from the Pediatric Nephrology Research Consortium

Session Information

Category: Dialysis

  • 703 Dialysis: Peritoneal Dialysis

Authors

  • Schuh, Meredith Posner, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, United States
  • Nehus, Edward, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, United States
  • Ehlayel, Abdulla, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, United States
  • Clark, Stephanie L., The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, United States
  • Chishti, Aftab S., University of Kentucky Medical Center, Lexington, Kentucky, United States
  • Edwards- Richards, Alcia D., Wake Forest Baptist Health, Winston-Salem, North Carolina, United States
  • Jernigan, Stephanie M., Children's Healthcare of Atlanta Inc, Atlanta, Georgia, United States
  • Kamel, Margret, Emory University, Atlanta, Georgia, United States
  • Luckritz, Kera E., University of Michigan, Ann Arbor, Michigan, United States
  • Magella, Bliss, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, United States
  • Mansuri, Asif, Augusta University, Augusta, Georgia, United States
  • Wilson, Amy C., Indiana University Health, Indianapolis, Indiana, United States
  • Claes, Donna J., Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, United States
Background

There are no recommended guidelines for performing omentectomy at the time of peritoneal dialysis (PD) catheter placement in the pediatric population. There are no multi-center studies investigating omentectomy and PD catheter revision in the pediatric dialysis population.

Methods

A multi-center, retrospective study was performed through the Pediatric Nephrology Research Consortium (PNRC). Data review included all incident tunneled PD catheters placed between 1/1/2011 – 12/31/2016 for first-time PD patients (ages 0-20). The primary outcome was the need for catheter revision and/or replacement following initial placement. Multivariable logistic regression was used to determine the independent association of omentectomy with catheter revision/replacement.

Results

Data from 184 patients (62.5 % male; 35.4 % glomerulonephritis) from 8 centers were analyzed. Median age at PD catheter insertion was 7.4 years. Omentectomy was performed in 67 children at the time of catheter placement (36.4%). Revision or replacement was required in 63 children (34.2%); median time to revision/replacement was 38.5 days (IQR 20.5, 109) after catheter insertion. Revision/replacement of the catheter occurred in 23.9% who had an omentectomy, compared to 52.2% without omentectomy (p=0.0005). Compared to younger children, those ≥ 6 years of age at the time of PD catheter placement had decreased risk of catheter revision/replacement (18.2% age ≥ 6 vs 56.5% age < 6, p <0.001). After adjusting for all clinical and surgical covariates, omentectomy reduced need for revision by almost 70%, and revision was 4x more likely in those < 6 years of age.

Conclusion

This multi-center study is the first to show that omentectomy at the time of PD catheter placement in pediatric patients is associated with decreased PD catheter revisions. Omentectomy should be strongly considered at the time of PD catheter placement, especially in children < 6 years of age who are at high risk for PD catheter malfunction.