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Abstract: TH-PO306

A Feasibility Study to Establish Dialysate Flow Characteristics in Peritoneal Dialysis to Associate Outflow Dysfunction

Session Information

  • Home Dialysis - I
    November 02, 2023 | Location: Exhibit Hall, Pennsylvania Convention Center
    Abstract Time: 10:00 AM - 12:00 PM

Category: Dialysis

  • 802 Dialysis: Home Dialysis and Peritoneal Dialysis

Authors

  • Gupta, Nupur, Indiana University School of Medicine, Indianapolis, Indiana, United States
  • Lane, Kathleen A., Indiana University School of Medicine, Indianapolis, Indiana, United States
  • Li, Yang, Indiana University School of Medicine, Indianapolis, Indiana, United States
  • Miller, Brent W., Indiana University School of Medicine, Indianapolis, Indiana, United States
Background

Peritoneal dialysis (PD) catheter dysfunction is the second leading cause of technique failure in PD after peritonitis. Failure to recognize this complication early result in techinique failure. Dialysate flow characteristics have been measured in the past for modeling automated PD dwell and drain time for clearance of solute rather than catheter dysfunction. We hypothesize dialysate flow characteristics are associated with outflow dysfunction.

Methods

The study was a prospective observational study measuring dialysate flow characteristics in incident PD patients. Dialysate flow rates were measured by standardized method weighing the drained volumes every 5 minutes up to maximum of 30 min or complete drainage of fluid up to 3 times during Training. The catheter-related complications were recorded during the study visits and then monthly up to 6 months. Patient characteristics at study entry were summarized by mean ± SD and proportions. Repeated-measure Poisson regression was performed to analyze incidences rates during and after training.

Results

21 patients were consented; 3 withdrew. 17/21 patients had completed flow records. The mean age at study entry was 53.3 ± 16.9 years, and 58.8% were men. Two out of three training visits were used for analysis. The mean drain time for training visits (both sitting and reclined) was 17.9 ±8.1 min. 52.9% and 64.7 % of patients reported catheter related complications in training and follow up visits respectively. Drain pain was the most reported complication during training while catheter dysfunction was most common during follow up visits. SThe sitting total time ≥ 10 minutes from first training visit was associated with 83% lower odd risk incidents rates of complications in training (incidents rates ratio (IRR) - 0.17, CI - 0.050-0.581, P= 0.005). Catheter dysfunction in training was associated with complications during monthly visits (IRR -1.66, CI-1.01-2.73, P= 0.0477).

Conclusion

Our study established feasibility of measuring dialysate flow characteristics and reports PD catheter complication rate. The drain time ≥ 10 min is associated with reduced catheter related complications in training due to early intervention by the clinical staff. Catheter dysfunction in training increases the odds of complications during monthly visits.

Funding

  • Clinical Revenue Support