Evaluation of a Training Program in Peritoneal Dialysis Catheter Insertion for Nephrologists in South America.

Abstract

Introduction: For patients requiring renal replacement therapy (RRT), peritoneal dialysis (PD) offers an alternative to maintain quality of life. The long-term success of PD depends on using a safe, functional, and durable peritoneal catheter (PC). This study aimed to assess the outcomes of a training program for nephrologists on PD catheter insertion in South American dialysis centers.

Methods: This longitudinal, retrospective, multicenter study was conducted in Colombia, Chile, Ecuador, and Bolivia. Patients who underwent PC insertion between January 2022 and May 2023 were included, with procedures performed by nephrologists trained in a specialized program. Data on population characteristics, procedural details, and catheter function at the first, third, and sixth months were collected.

Results: A total of 117 subjects were included (median age 59 years, 50.4% men). Hypertension and diabetes were the primary causes of kidney disease (34.19% and 49.57%, respectively). Bladder emptying and prophylactic antibiotics were administered before the procedure. Most PC insertions (86.32%) were performed under local anesthesia, with the modified Seldinger technique. Catheter implantation was successful in 96.58% of cases. Elective PD was performed in 69.91% of patients, while 30.01% required urgent PD. Within the first two weeks, complications occurred in 7.08% of patients, including catheter tip migration and flow failure. At one, three, and six months of follow-up, complications were observed in 1.79%, 3.77%, and 11.00% of patients, respectively. Catheter patency was maintained in 99.10%, 96.22%, and 96.00% of patients at one, three, and six months, respectively.

Conclusions: Optimal peritoneal access can be achieved through educational programs for nephrologists on catheter insertion, ensuring proper placement and maintenance, and resulting in low complication rates in PD patients.