Pediatric Surgery International

, Volume 34, Issue 11, pp 1239–1244 | Cite as

Peritoneal dialysis catheter placement, outcomes and complications

  • Melanie B. LaPlant
  • Daniel A. Saltzman
  • Bradley J. Segura
  • Robert D. Acton
  • Brad A. Feltis
  • Donavon J. HessEmail author
Original Article



Peritoneal dialysis (PD) is a commonly used method for renal support in pediatric patients and can be associated with the risk of post-surgical complications. We evaluated method of placement of PD catheters with regard to post-surgical complications.


PD catheters placed at two institutions between 2005 and 2017 were reviewed. Complication rates were evaluated based on method of placement, delayed usage, omentectomy, and patient age using Fisher’s exact test, two-sided, with significance set at 0.05. Factors influencing complication were evaluated with multivariate logistic regression and Kaplan–Meier survival analysis.


There were 130 patients with 157 catheters placed, ranging in age from 1 day to 23 years. There was no significant difference in complication rate by method of placement or delayed usage. Infants were significantly more likely to experience leakage (21% vs 8%, p 0.036) and hernias (15% vs 5%, p 0.030). Patients that underwent an omentectomy were less likely to require a catheter replacement (7% vs 27%, p 0.004), and the catheters had a significantly higher survival rate (p 0.009). We found that laparoscopic intervention resulted in catheter salvage. Lateral exit sites may be a risk factor for catheter migration in some patients.


Omentectomy is associated with longer PD catheter survival. Laparoscopic salvage of dysfunctional catheters may be a valuable adjunct in management.


Peritoneal dialysis Pediatric Omentectomy Laparoscopic Laparoscopic salvage 




Compliance with ethical standards

Conflict of interest

MB LaPlant declares that she has no conflict of interest. DA Saltzman declares that he has no conflict of interest. BJ Segura declares that he has no conflict of interest. RD Acton declares that he has no conflict of interest. B Feltis declares that he has no conflict of interest. DJ Hess declares that he has no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

For this type of study formal consent is not required.


  1. 1.
    Washburn KK, Currier H, Salter KJ, Brandt ML (2004) Surgical technique for peritoneal dialysis catheter placement in the pediatric patient: a North American Survey. Adv Perit Dial 20:218–221PubMedGoogle Scholar
  2. 2.
    Ustyol L, Peker E, Demir N, Agengin K, Tuncer O (2016) The use of acute peritoneal dialysis in critically Ill newborns. Med Sci Monit 22:1421–1426. CrossRefPubMedPubMedCentralGoogle Scholar
  3. 3.
    Mattioli G, Castagnetti M, Verrina E, Trivelli A, Torre M, Jasonni V et al (2007) Laparoscopic-assisted peritoneal dialysis catheter implantation in pediatric patients. Pediatr Urol 69:1185–1189. CrossRefGoogle Scholar
  4. 4.
    Lane JC, Warady BA, Feneberg R, Majkowski NL, Watson AR, Fischbach M et al (2010) Relapsing peritonitis in children who undergo chronic peritoneal dialysis: a prospective study of the international pediatric peritonitis registry. Clin J Am Soc Nephrol 5:1041–1046. CrossRefPubMedPubMedCentralGoogle Scholar
  5. 5.
    Yavascan O, Anil M, Kara OD, Bal A, Akcan N, Senturk S (2011) The Comparison of exit-site care with normal saline and povidone–iodine in preventing exit-site infection and peritonitis in children on chronic peritoneal dialysis treatment. Saudi J Kidney Dis Transpl 22:931–934PubMedGoogle Scholar
  6. 6.
    Bakkaloglu S (2009) Prevention of peritonitis in children: emerging concepts. Perit Dial Int 29:S186–S189PubMedGoogle Scholar
  7. 7.
    Carpenter JL, Fallon SC, Swartz SJ, Minifee PK, Cass DL, Nuchtern JG et al (2016) Outcomes after peritoneal dialysis catheter placement. J Pediatr Surg 51:730–733. CrossRefPubMedGoogle Scholar
  8. 8.
    Cribbs RK, Greenbaum LA, Heiss KF (2010) Risk factors for early peritoneal dialysis catheter failure in children. J Pediatr Surg 45:585–589. CrossRefPubMedGoogle Scholar
  9. 9.
    Macchini F, Valade ÆA (2006) Chronic peritoneal dialysis in children: catheter related complications. A single centre experience. Pediatr S 22:524–528. CrossRefGoogle Scholar
  10. 10.
    Ladd AP, Breckler FD, Novotny NM (2011) Impact of primary omentectomy on longevity of peritoneal dialysis catheters in children. AJS 201:401–405. CrossRefGoogle Scholar
  11. 11.
    Phan J, Stanford S, Zaritsky JJ, Deugarte DA (2013) Risk factors for morbidity and mortality in pediatric patients with peritoneal dialysis catheters. J Pediatr Surg 48:197–202. CrossRefPubMedGoogle Scholar
  12. 12.
    Numanoglu A, Rasche L, Roth MA, McCulloch MI, Rode H (2008) Laparoscopic insertion with tip suturing, omentectomy, and ovariopexy improves lifespan of peritoneal dialysis catheters in children. J Laparoendosc Adv Surg Tech 18:302–305. CrossRefGoogle Scholar
  13. 13.
    Radtke J, Schild R, Reismann M, Ridwelski R, Kempf C, Nashan B et al (2017) Obstruction of peritoneal dialysis catheter is associated with catheter type and independent of omentectomy: a comparative data analysis from a transplant surgical and a pediatric surgical department. J Pediatr Surg. CrossRefPubMedGoogle Scholar
  14. 14.
    White CT, Gowrishankar M, Feber J, Yiu V, Association C (2006) Clinical practice guidelines for pediatric peritoneal dialysis. Pediatr Nephrol 21:1059–1066. CrossRefPubMedGoogle Scholar
  15. 15.
    Warady BA, Bakkaloglu S, Newland J, Cantwell M, Verrina E, Neu A et al (2012) Consensus guidelines for the prevention and treatment of catheter-related infections and peritonitis in pediatric patients receiving peritoneal dialysis: 2012 update. Perit Dial Int 32:S32–S86. CrossRefPubMedPubMedCentralGoogle Scholar
  16. 16.
    Rahim KA, Seidel K, Mcdonald RA (2004) Risk factors for catheter-related complications in pediatric peritoneal dialysis. Pediatr Nephrol 19:1021–1028. CrossRefPubMedGoogle Scholar
  17. 17.
    Beanes SR, Kling KM, Fonkalsrud EW, Torres M, Salusky IB, Quinones-baldrich WJ et al (2000) Surgical aspects of dialysis in newborns and infants weighing less than 10 kg. J Pediatr Surg 35:1543–1548. CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  • Melanie B. LaPlant
    • 1
  • Daniel A. Saltzman
    • 1
  • Bradley J. Segura
    • 1
  • Robert D. Acton
    • 1
  • Brad A. Feltis
    • 2
  • Donavon J. Hess
    • 1
    Email author
  1. 1.Division of Pediatric Surgery, Department of SurgeryUniversity of MinnesotaMinneapolisUSA
  2. 2.Pediatric Surgical AssociatesChildren’s Hospitals and Clinics of MinnesotaMinneapolisUSA

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