Outcomes of Percutaneous Peritoneal Dialysis Catheters Insertion by Interventional Radiologists: A Single-Institution Experience

Khadijah A. Alhussaini, Shaima Abulqasim, A. Al-Sharydah, E. Elhassan, M. Arabi
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Abstract

Abstract Objectives  This article evaluates the short- and long-term outcomes of percutaneous peritoneal dialysis (PD) catheters inserted by interventional radiology service and analyzes the factors that affect the sustainability of patent and functional PD catheters. Materials and Methods  Retrospective single-institution study between April 2015 and February 2021. A total of 131 patients (75 males) were enrolled with mean age of 50 ± 19.6 years with an average body mass index (BMI) of 28 ± 7 kg/m 2 . Technical and clinical success were evaluated. Catheter-related complications were classified into mechanical and nonmechanical categories, including infectious complications. Indications for removal were analyzed. Results  Technical and clinical success were 100%. The average dwelling time for the entire cohort was 497.5 ± 462.3 days. Forty-six patients (35%) were on PD at the last follow-up with an average dwelling time of 492 days. PD-related complications were reported in 79/131 (60.3%) patients, including peritonitis (40.46%; 53/131), followed by malposition/migration (12.21%; 16/131), tunnel/exit site infection (10.69%; 14/131), and dysfunction (12.21%; 16/131). The incidence of peritonitis within 30 days postinsertion was 9.43% (5/53). The average interval between insertion and migration was 100.5 ± 144.8 days (95% confidence interval, 6.9–14.4). There was a trend for a higher rate of malposition/migration in patients with higher BMI ( p  = 0.0561). Causes for PD catheters removal were: (1) infection-related (24.4%; 32/131), (2) renal transplant recipients (16%; 21/131), (3) mechanical complications (13.7%; 18/131), and (4) patient's preference (7.6%; 10/131). Conclusion  Percutaneous PD catheter placement by interventional radiologists provides acceptable long-term outcomes and complication rates that meet the recommended standards.
介入放射科医师插入经皮腹膜透析导管的结果:单一机构的经验
【摘要】目的评价介入放射科置入经皮腹膜透析(PD)导管的近期和长期疗效,分析影响PD导管通畅和功能可持续性的因素。材料与方法2015年4月至2021年2月的回顾性单机构研究。共纳入131例患者(男性75例),平均年龄50±19.6岁,平均体重指数(BMI) 28±7 kg/ m2。评估技术和临床成功。导管相关并发症分为机械性和非机械性两类,包括感染性并发症。分析手术指征。结果技术及临床成功率100%。整个队列的平均居住时间为497.5±462.3天。46例(35%)患者在最后一次随访时仍在PD治疗,平均居住时间为492天。131例患者中有79例(60.3%)出现pd相关并发症,包括腹膜炎(40.46%);53/131),其次是位错/移位(12.21%;16/131),隧道/出口站点感染(10.69%);14/131),功能障碍(12.21%;16/131)。插入后30天腹膜炎发生率为9.43%(5/53)。插入和迁移之间的平均间隔为100.5±144.8天(95%置信区间为6.9-14.4)。BMI越高的患者体位移位率越高(p = 0.0561)。PD导管拔除原因:(1)感染相关(24.4%);(32/131);(2)肾移植受者(16%;(3)机械性并发症(13.7%);18/131),(4)患者偏好(7.6%;10/131)。结论介入放射科医师经皮PD导管置入可提供可接受的长期预后和符合推荐标准的并发症发生率。
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