Catheter placement by nephrologists: A safe and effective method for improving access to peritoneal dialysis

Introduction: Peritoneal dialysis (PD) is an effective treatment option for patients with kidney failure and offers them a better quality of life. Despite its advantages, PD remains underutilized, particularly in Morocco. The aim of our study was to evaluate the impact of catheter placement by nephrologists on the number of incident PD patients, compare the success rates of this technique with those of surgical placement, and assess the short- and long-term complications associated with the two approaches.

Methods: This was a single-center retrospective study including 69 PD patients, conducted from January 2008 to December 2022.

Results: A total of 28 patients received PD catheter placement by nephrologists (Group A), while 41 underwent the procedure performed by urologists (Group B). Since the introduction of nephrologist-led catheter placement, the incidence of patients starting PD significantly increased, with a growth rate of over 100% every two years. The waiting time for catheter placement was significantly shorter in Group A (5 days versus 20 days; p < 0.001). No significant difference was observed in the incidence of short-term mechanical and infectious complications between the two groups. Although univariable analysis revealed a higher incidence of long-term mechanical and infectious complications in Group B compared to group A, this difference was not statistically significant in multivariable analysis (p > 0.05). The success rate of PD catheter placement in Group A was 92.85%, while it was 97.56% in Group B. The one-year catheter survival rate was significantly higher in Group B than in Group A (100% versus 75%; p = 0.031), and mean catheter survival was significantly longer in Group B (17 months versus 11 months; p = 0.026).

Conclusion: PD catheter placement by nephrologists proved to be a safe and effective approach.