OUTCOMES OF THE WEIGHTED PERITONEAL DIALYSIS CATHETER IN PATIENTS AT RISK OF PERCUTANEOUS CATHETER FAILURE.

Stonelake, Stephen and Baharani, Jyoti and Thomas, Mark and Adkins, Roger and Hollingsworth, Lee and Wilmink, Teun (2018) OUTCOMES OF THE WEIGHTED PERITONEAL DIALYSIS CATHETER IN PATIENTS AT RISK OF PERCUTANEOUS CATHETER FAILURE. Peritoneal dialysis international : journal of the International Society for Peritoneal Dialysis. ISSN 1718-4304.

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Official URL: http://www.pdiconnect.com/content/early/2018/11/25...

Abstract

BACKGROUND

The weighted catheter has shown promising results in retrospective and randomized studies. We examined its usefulness in patients with previous failed non-weighted peritoneal dialysis (PD) catheters or previous abdominal surgery.

METHODS

The insertion, start, end, and removal dates were recorded for all-type catheter insertions from 2011 to 2016. Primary and secondary failure rates were recorded, defined as failure to ever establish flow (primary) or failure after a period of successful PD (secondary). Patients were censored from analysis if PD ended due to death, transfer of care, transfer to hemodialysis, transplantation, or if the patient recovered renal function.

RESULTS

There were 44 weighted, 75 non-weighted open surgical, and 143 percutaneous catheters. There was previous abdominal surgery in 29% and 6% of patients receiving surgically inserted and percutaneous catheters, respectively (p < 0.0001). Primary failure rates were 4/44 (9%), 20/75 (27%), and 26/143 (18%) in weighted, non-weighted surgical, and percutaneous catheters, respectively. There were reduced primary and secondary failure rates in the weighted (9% primary and 15% secondary) versus non-weighted surgically inserted group (27% primary and 46% secondary) (p = 0.04). There was no difference between primary (p= 0.15) and secondary (p = 0.5) failure rates between weighted and percutaneously inserted catheters. Kaplan-Meier survival analysis revealed overall increased catheter survival in the weighted group (p = 0.02).

CONCLUSION

Weighted catheters were associated with increased survival and decreased failure rates compared with non-weighted surgical catheters, despite usage in patients at higher risk of catheter failure due to previous failed catheters and abdominal surgery.

Item Type: Article
Subjects: WJ Urogenital system. Urology
Divisions: Emergency Services > Renal
Planned IP Care > Vascular
Related URLs:
Depositing User: Mrs Yolande Brookes
Date Deposited: 30 Nov 2018 12:43
Last Modified: 30 Nov 2018 12:43
URI: http://www.repository.heartofengland.nhs.uk/id/eprint/1790

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