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Ren Fail. 2019 Nov;41(1):434-438. doi: 10.1080/0886022X.2019.1614058.

Bedside placement of peritoneal dialysis catheters - a single-center experience from Hungary.

Author information

1
a 1st Department of Internal Medicine, Faculty of Medicine , Semmelweis University , Budapest , Hungary.
2
b Department of Surgery, Faculty of Medicine , University of Debrecen , Debrecen , Hungary.
3
c Medical Services , Ralph H. Johnson VA Medical Center , Charleston , SC , USA.
4
d Hemodialysis Unit , Fresenius Medical Care Hungary , Hatvan , Hungary.
5
e Department of Pathophysiology, International Nephrology Research and Training Center , Semmelweis University , Budapest , Hungary.

Abstract

Objectives: The successful implantation of peritoneal dialysis (PD) catheters is a critical skill procedure with the potential to impact both the short- and long-term success of renal replacement therapy and the patients' survival. Methods: We retrospectively reviewed our single-center experience with nephrologist-placed minimally invasive, double-cuffed PD catheters (PDCs). Results: The recruitment period was March 2014 through December 2015. The follow-up period lasted until 2016. The mean age of the subjects was 60 ± 18 years and indications for the PD were diuretic resistant acutely decompensated chronic heart failure in seven patients (47%) and end-stage renal disease in eight (53%) patients. Comorbid conditions included diabetes (27%), ischemic heart disease (47%), advanced liver failure (27%), and a history of hypertension (73%). The cohort had a high mortality with five subjects only in severe heart failure group (33%) passing away during the index hospitalization; of the rest, two (13%) had heart transplantation, three (20%) changed modality to hemodialysis, and only five (33%) continued with maintenance PD beyond 1 month. Acute technical complications within the first month were infrequent: one catheter (6%) had drainage problems and one (6%) was lost due to extrusion. There were no serious complications (e.g., organ damage, peritonitis, etc.). Conclusions: In selected cases, particularly in severe diuretic refractory heart failure, PDC placement placed by a nephrologist is feasible with a low rate of complications even in a low-volume center setting. The catheters we placed were all functioning with only minor complications and PD could be started immediately.

KEYWORDS:

Heart failure; PD catheter; minimally invasive; percutaneous; peritoneal dialysis

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