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Peritoneal dialysis catheter placement, outcomes and complications

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Abstract

Purpose

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.

Methods

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.

Results

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.

Conclusions

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

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Authors and Affiliations

  1. Division of Pediatric Surgery, Department of Surgery, University of Minnesota, 2450 Riverside Ave S. MB 505, Minneapolis, MN, 55454, USA

    Melanie B. LaPlant, Daniel A. Saltzman, Bradley J. Segura, Robert D. Acton & Donavon J. Hess

  2. Pediatric Surgical Associates, Children’s Hospitals and Clinics of Minnesota, Minneapolis, MN, USA

    Brad A. Feltis

Authors
  1. Melanie B. LaPlant
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  2. Daniel A. Saltzman
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  3. Bradley J. Segura
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  4. Robert D. Acton
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  5. Brad A. Feltis
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  6. Donavon J. Hess
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Corresponding author

Correspondence to Donavon J. Hess.

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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.

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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.

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LaPlant, M.B., Saltzman, D.A., Segura, B.J. et al. Peritoneal dialysis catheter placement, outcomes and complications. Pediatr Surg Int 34, 1239–1244 (2018). https://doi.org/10.1007/s00383-018-4342-1

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  • DOI: https://doi.org/10.1007/s00383-018-4342-1

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