{"title":"一项日本腹膜透析置管后的多机构观察性研究。","authors":"Tsutomu Sakurada, Shigeki Kojima, Shohei Yamada, Kenichiro Koitabashi, Yasuhiro Taki, Katsuomi Matsui, Masaru Murasawa, Hiroo Kawarazaki, Sayaka Shimizu, Hironori Kobayashi, Toshihiro Asai, Koji Hashimoto, Taro Hoshino, Seita Sugitani, Tomochika Maoka, Akihiko Nagase, Hirotaka Sato, Kosuke Fukuoka, Tadashi Sofue, Kiyoto Koibuchi, Kiyomitsu Nagayama, Naoki Washida, Shigehisa Koide, Takayuki Okamoto, Daisuke Ishii, Satoshi Furukata, Kiyotaka Uchiyama, Shunsuke Takahashi, Yoshiko Nishizawa, Shotaro Naito, Naohiro Toda, Tsukasa Naganuma, Hidetoshi Kikuchi, Tomo Suzuki, Daisuke Komukai, Takahide Kimura, Hiroaki Io, Kazuhiro Yoshikawa, Toshihide Naganuma, Masamitsu Morishita, Jin Oshikawa, Keiichi Tamagaki, Hajime Fujisawa, Atsushi Ueda, Tomohiko Kanaoka, Hironori Nakamura, Mai Yanagi, Takashi Udagawa, Tatsuo Yoneda, Masashi Sakai, Masanobu Gunji, Shinichi Osaki, Hisako Saito, Yuuki Yoshioka, Nagayuki Kaneshiro","doi":"10.1177/08968608231193240","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>This multi-institutional, observational study examined whether the outcomes after peritoneal dialysis (PD) catheter placement in Japan meet the audit criteria of the International Society for Peritoneal Dialysis (ISPD) guideline and identified factors affecting technique survival and perioperative complications.</p><p><strong>Methods: </strong>Adult patients who underwent first PD catheter placement for end-stage kidney disease between April 2019 and March 2021 were followed until PD withdrawal, kidney transplantation, transfer to other facilities, death, 1 year after PD start or March 2022, whichever came first. Primary outcomes were time to catheter patency failure and technique failure, and perioperative infectious complications within 30 days of catheter placement. Secondary outcomes were perioperative complications. Appropriate statistical analyses were performed to identify factors associated with the outcomes of interest.</p><p><strong>Results: </strong>Of the total 409 patients, 8 who underwent the embedded catheter technique did not have externalised catheters. Of the 401 remaining patients, catheter patency failure occurred in 25 (6.2%). Technical failure at 12 months after PD catheter placement calculated from cumulative incidence function was 15.3%. On Cox proportional hazards model analysis, serum albumin (hazard ratio (HR) 0.44; 95% confidence interval (CI) 0.27-0.70) and straight type catheter (HR 2.14; 95% CI 1.24-3.69) were the independent risk factors for technique failure. On logistic regression analysis, diabetes mellitus was the only independent risk factor for perioperative infectious complications (odds ratio 2.70, 95% CI 1.30-5.58). The occurrence rate of perioperative complications generally met the audit criteria of the ISPD guidelines.</p><p><strong>Conclusion: </strong>PD catheter placement in Japan was proven to be safe and appropriate.</p>","PeriodicalId":19969,"journal":{"name":"Peritoneal Dialysis International","volume":null,"pages":null},"PeriodicalIF":2.7000,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"1","resultStr":"{\"title\":\"A multi-institutional, observational study of outcomes after catheter placement for peritoneal dialysis in Japan.\",\"authors\":\"Tsutomu Sakurada, Shigeki Kojima, Shohei Yamada, Kenichiro Koitabashi, Yasuhiro Taki, Katsuomi Matsui, Masaru Murasawa, Hiroo Kawarazaki, Sayaka Shimizu, Hironori Kobayashi, Toshihiro Asai, Koji Hashimoto, Taro Hoshino, Seita Sugitani, Tomochika Maoka, Akihiko Nagase, Hirotaka Sato, Kosuke Fukuoka, Tadashi Sofue, Kiyoto Koibuchi, Kiyomitsu Nagayama, Naoki Washida, Shigehisa Koide, Takayuki Okamoto, Daisuke Ishii, Satoshi Furukata, Kiyotaka Uchiyama, Shunsuke Takahashi, Yoshiko Nishizawa, Shotaro Naito, Naohiro Toda, Tsukasa Naganuma, Hidetoshi Kikuchi, Tomo Suzuki, Daisuke Komukai, Takahide Kimura, Hiroaki Io, Kazuhiro Yoshikawa, Toshihide Naganuma, Masamitsu Morishita, Jin Oshikawa, Keiichi Tamagaki, Hajime Fujisawa, Atsushi Ueda, Tomohiko Kanaoka, Hironori Nakamura, Mai Yanagi, Takashi Udagawa, Tatsuo Yoneda, Masashi Sakai, Masanobu Gunji, Shinichi Osaki, Hisako Saito, Yuuki Yoshioka, Nagayuki Kaneshiro\",\"doi\":\"10.1177/08968608231193240\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>This multi-institutional, observational study examined whether the outcomes after peritoneal dialysis (PD) catheter placement in Japan meet the audit criteria of the International Society for Peritoneal Dialysis (ISPD) guideline and identified factors affecting technique survival and perioperative complications.</p><p><strong>Methods: </strong>Adult patients who underwent first PD catheter placement for end-stage kidney disease between April 2019 and March 2021 were followed until PD withdrawal, kidney transplantation, transfer to other facilities, death, 1 year after PD start or March 2022, whichever came first. Primary outcomes were time to catheter patency failure and technique failure, and perioperative infectious complications within 30 days of catheter placement. Secondary outcomes were perioperative complications. Appropriate statistical analyses were performed to identify factors associated with the outcomes of interest.</p><p><strong>Results: </strong>Of the total 409 patients, 8 who underwent the embedded catheter technique did not have externalised catheters. Of the 401 remaining patients, catheter patency failure occurred in 25 (6.2%). Technical failure at 12 months after PD catheter placement calculated from cumulative incidence function was 15.3%. On Cox proportional hazards model analysis, serum albumin (hazard ratio (HR) 0.44; 95% confidence interval (CI) 0.27-0.70) and straight type catheter (HR 2.14; 95% CI 1.24-3.69) were the independent risk factors for technique failure. On logistic regression analysis, diabetes mellitus was the only independent risk factor for perioperative infectious complications (odds ratio 2.70, 95% CI 1.30-5.58). The occurrence rate of perioperative complications generally met the audit criteria of the ISPD guidelines.</p><p><strong>Conclusion: </strong>PD catheter placement in Japan was proven to be safe and appropriate.</p>\",\"PeriodicalId\":19969,\"journal\":{\"name\":\"Peritoneal Dialysis International\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":2.7000,\"publicationDate\":\"2023-11-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"1\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Peritoneal Dialysis International\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1177/08968608231193240\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2023/8/26 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q2\",\"JCRName\":\"UROLOGY & NEPHROLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Peritoneal Dialysis International","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1177/08968608231193240","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2023/8/26 0:00:00","PubModel":"Epub","JCR":"Q2","JCRName":"UROLOGY & NEPHROLOGY","Score":null,"Total":0}
A multi-institutional, observational study of outcomes after catheter placement for peritoneal dialysis in Japan.
Background: This multi-institutional, observational study examined whether the outcomes after peritoneal dialysis (PD) catheter placement in Japan meet the audit criteria of the International Society for Peritoneal Dialysis (ISPD) guideline and identified factors affecting technique survival and perioperative complications.
Methods: Adult patients who underwent first PD catheter placement for end-stage kidney disease between April 2019 and March 2021 were followed until PD withdrawal, kidney transplantation, transfer to other facilities, death, 1 year after PD start or March 2022, whichever came first. Primary outcomes were time to catheter patency failure and technique failure, and perioperative infectious complications within 30 days of catheter placement. Secondary outcomes were perioperative complications. Appropriate statistical analyses were performed to identify factors associated with the outcomes of interest.
Results: Of the total 409 patients, 8 who underwent the embedded catheter technique did not have externalised catheters. Of the 401 remaining patients, catheter patency failure occurred in 25 (6.2%). Technical failure at 12 months after PD catheter placement calculated from cumulative incidence function was 15.3%. On Cox proportional hazards model analysis, serum albumin (hazard ratio (HR) 0.44; 95% confidence interval (CI) 0.27-0.70) and straight type catheter (HR 2.14; 95% CI 1.24-3.69) were the independent risk factors for technique failure. On logistic regression analysis, diabetes mellitus was the only independent risk factor for perioperative infectious complications (odds ratio 2.70, 95% CI 1.30-5.58). The occurrence rate of perioperative complications generally met the audit criteria of the ISPD guidelines.
Conclusion: PD catheter placement in Japan was proven to be safe and appropriate.
期刊介绍：
Peritoneal Dialysis International (PDI) is an international publication dedicated to peritoneal dialysis. PDI welcomes original contributions dealing with all aspects of peritoneal dialysis from scientists working in the peritoneal dialysis field around the world.
Peritoneal Dialysis International is included in Index Medicus and indexed in Current Contents/Clinical Practice, the Science Citation Index, and Excerpta Medica (Nephrology/Urology Core Journal). It is also abstracted and indexed in Chemical Abstracts (CA), as well as being indexed in Embase as a priority journal.
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