Abstract: PUB073
First Peritoneal Access for Dialysis: Percutaneous vs. Surgical Placement in a Mexican Cohort
Session Information
Category: Dialysis
- 802 Dialysis: Home Dialysis and Peritoneal Dialysis
Author
- Bahena Carrera, Lucino, Mexico Secretaria de la Defensa Nacional, Mexico City, CDMX, Mexico
Group or Team Name
- Military nephrologists
Background
Briggs VR mentioned high quality, evidence based data are urgently required, utilising multicentre RCTs or large cohort studies available to guide clinicians in deciding the best peritoneal access for CKDs patients.
Methods
Observational, analytical, retrospective cohort study. All incident CKD patients older than 6 years who started peritoneal dialysis at our hospital; were admitted from January 2012 to May 2018 by placing a first Tenckhoff pigtail double cuff catheter using the Seldinger technique performed by nephrologists vs surgical by surgeons. Descriptive (mean/SD) and analytical statistics was performed (Xi square, t student, one way ANOVA and survival analysis with Kaplan Meier) to analyze demographic variables, mechanical and infectious complications, 1 year catheters survival; Bonferroni correction was performed, p <0.05 was statistically significant.
Results
Were admitted 1,045 patients, and finally, 648 were included in the surgical access arm and 356 in percutaneous arm. Within the surgical group, there was a subgroup of 284 patients without prior abdominal surgery.
Mean BMI 26.2+4.1 kg/ m2BS, female 51.3%, albumin 2.0+0.6 g/dL, fluid overload was 7.9+6.8%.
The break-in period in surgical arm was 4.4 (+0.9) days and 2.5 (+0.8) days in percutaneous arm, p=0.035.
Percutaneous group had fewer complications (47.8%, p<0.001) compared to two surgical groups and there were less peritonitis, minor dysfunctions, tunnelitis, viscera perforation and leaks (p<0.001).
Percutaneous access had 80% functionality vs 74.65% surgical group (p=0.412). One-year after placement, percutaneous access survival tended to be better than surgery group, although without statistical significance (p=0.343) figure 1.
Conclusion
In mexican population, percutaneous technical catheter insertion by nephrologists it's safer and statistically tends to have better catheter survival than surgical peritoneal access.
Acknowledgment
My nephrologists team and patients.
Catheter survival