Abstract: FR-PO530
Medical, Radiological, and Surgical Peritoneal Dialysis Catheter Insertion Outcomes at a Single UK Centre
Session Information
- Home Dialysis, Policy, Novel Approaches
November 04, 2022 | Location: Exhibit Hall, Orange County Convention Center‚ West Building
Abstract Time: 10:00 AM - 12:00 PM
Category: Dialysis
- 702 Dialysis: Home Dialysis and Peritoneal Dialysis
Authors
- Banham, Gemma D., University Hospitals Birmingham NHS Foundation Trust, Birmingham, United Kingdom
- Tabinor, Matthew, University Hospitals Birmingham NHS Foundation Trust, Birmingham, United Kingdom
- Mahdi, Amar Monaf, University Hospitals Birmingham NHS Foundation Trust, Birmingham, United Kingdom
- Baharani, Jyoti B., University Hospitals Birmingham NHS Foundation Trust, Birmingham, United Kingdom
Background
We sought to determine success rates of peritoneal dialysis (PD) catheters inserted at our centre.
Methods
Audit of PD catheter outcomes from 2019 to 2021 at Birmingham Heartlands Hospital (BHH), University Hospitals Birmingham NHS Foundation Trust (UHB). Surgery was performed at BHH and Queen Elizabeth Hospital Birmingham, UHB.
Results
In 182 patients referred for PD catheter placement, 220 procedures were performed (83 (37.7%) medical, 80 (36.4%) radiological, 57 (25.9%) surgical). The initial insertion attempt was successful in 128/182 (70.3%) cases - 56/83 (67.5 %) medical, 44/60 (73.3%) radiological and 28/39 (71.8%) surgical. Catheters were successfully sited in 28/35 (80.0%) patients on further attempts.
After failed medical placement, catheters were sited medically in 1/23 (4.3%), radiologically in 10/23 (43.5%) and surgically in 7/23 (30.4%), with 5/23 (21.7%) commencing haemodialysis (HD) after another failed attempt. After failed radiological placement, catheters were successfully sited in 1/8 (12.5%) radiologically and 6/8 (75.0%) surgically, with 1/8 (12.5%) commencing HD following unsuccessful placement. Surgical placement was successful with a second procedure in 2/4 (50%) of those failing surgical placement. 19 patients opted against a second attempt.
There were no differences in one year catheter survival between catheters inserted medically, radiologically and surgically (log rank test p=0.68). Catheter insertion modality, age, sex, ethnicity, cause of renal disease and index of multiple deprivation were not predictors of catheter failure in cox regression analysis.
Conclusion
Catheters placed medically were comparable to those placed radiologically and surgically and offer an option for PD catheter insertion in day case and acute settings in suitable patients. Without predictors of poor outcome, clinical judgement remains critical in determining patient suitability.