Analysis of Hospitalization after Peritoneal Dialysis Catheter Implantation

Li, Zi; Abreu, Zita; Penner, Todd; Lian, He; Liu, Xihui; Bargman, Joanne M.

doi:10.3747/pdi.2014.00333

Cited by 8 publications

(11 citation statements)

References 24 publications

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“…Peritoneal dialysis (PD) is a commonly used method of renal replacement therapy for ESRD patients. The readmission rates of PD patients were quite high, 15.5–37.4%, as reported in developed countries [ 1 , 4 , 5 ]. Although several studies have investigated the risk factors and prevention strategies of readmission among hemodialysis (HD) patients [ 6 – 9 ], evidence regarding the prevalence and modifiable risk factors of 30-day readmission among PD patients in developing countries was still limited.…”

Section: Introductionmentioning

confidence: 72%

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Prevalence, risk factors and impact on outcomes of 30-day unexpected rehospitalization in incident peritoneal dialysis patients

Huang

et al. 2021

BMC Nephrol

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Background Rehospitalization is a major problem for end stage renal disease (ESRD) populations. However, researches on 30-day unexpected rehospitalzation of incident peritoneal dialysis (PD) patients were limited. This study aimed to investigate the prevalence, risk factors and impact on outcomes of 30-day unexpected rehospitalization in incident PD patients. Methods This was a retrospective cohort study. Patients who accepted PD catheter implantation in our centre from Jan 1, 2006 to Dec 31, 2013 and regular follow-up were included. The demographic characteristics, laboratory parameters, and rehospitalization data were collected and analyzed. The primary outcome was all-cause mortality, and the secondary outcomes included cardiovascular disease (CVD) mortality and technical failure. Results Totally 1632 patients (46.9 ± 15.3 years old, 60.1% male, 25.6% with diabetes) were included. Among them, 149 (9.1%) had a 30-day unexpected rehospitalization after discharge. PD-related peritonitis (n = 48, 32.2%), catheter malfunction (n = 30, 20.1%) and severe fluid overload (n = 19, 12.8%) were the top three causes for the rehospitalization. Multivariate logistic regression analysis showed that length of index hospital stays [Odds ratio (OR) =1.02, 95% confidence interval (CI) 1.00–1.03, P = 0.036) and hyponatremia (OR = 1.85, 95% CI 1.06–3.24, P = 0.031) were independently associated with the rehospitalization. Multivariate Cox regression analysis indicated that 30-day rehospitalization was an independent risk factor for all-cause mortality [Hazard ratio (HR) =1.52, 95% CI 1.07–2.16, P = 0.019) and CVD mortality (HR = 1.73, 95% CI 1.03–2.90, P = 0.038). Conclusions The prevalence of 30-day unexpected rehospitalization for incident PD patients in our centre was 9.1%. The top three causes for the rehospitalization were PD-related peritonitis, catheter malfunction and severe fluid overload. Thirty-day unexpected rehospitalization increased the risk of all-cause mortality and CVD mortality for PD patients.

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Section: Introductionmentioning

confidence: 72%

“…Previous studies reported that rehospitalization rates were 15.8–37.5% in HD patients [ 1 , 4 , 6 , 7 , 9 ] and 15.5–37.4% in PD patients [ 1 , 4 , 5 ]. Compared to previous studies, the prevalence of 30-day unexpected rehospitalization in our study was much lower.…”

Section: Discussionmentioning

confidence: 99%

Prevalence, risk factors and impact on outcomes of 30-day unexpected rehospitalization in incident peritoneal dialysis patients

Huang

et al. 2021

BMC Nephrol

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“…PDC implantation and removal are common procedures in ESRD patients. GA-related perioperative cardiopulmonary complications and potential severe neurolog-ical complications due to coagulopathy make neither GA nor neuraxial block a good anesthetic solution for PDC procedures in ESRD patients [2,3]. Therefore, LAI is still a common anesthetic option for PDC procedures in developing countries.…”

Section: Discussionmentioning

confidence: 99%

“…Open dissection peritoneal dialysis catheter (PDC) implantation or removal is a common procedure in patients with end-stage renal diseases (ESRD) in developing countries [1]. Coexisting cardiopulmonary comorbidities and coagulation disorders make neither general anesthesia (GA) nor neuraxial block an optimal anesthetic solution in ESRD patients [2,3]. Local anesthetic infiltration (LAI) has minimal cardiopulmonary interference and is H.Z.…”

Section: Introductionmentioning

confidence: 99%

Single-Injection Ultrasound-Guided Thoracic Paravertebral Block versus Local Anesthetic Infiltration in Peritoneal Dialysis Catheter Surgeries: A Randomized Controlled Trial

Zhang

Jiang

et al. 2020

Blood Purif

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Introduction: Ultrasound-guided thoracic paravertebral block (US-TPVB) is generally used for postoperative analgesia. We hypothesized that single-injection US-TPVB could be used as the principal anesthetic technique for a peritoneal dialysis catheter (PDC) procedure (implantation or removal). The anesthetic effect and venous ropivacaine level after a TPVB would be compared with that after local anesthetic infiltration (LAI). Methods: Patients undergoing PDC procedures were randomized into Group LAI or TPVB. In Group LAI, 40 mL of 0.25% ropivacaine were used. In Group TPVB, single-injection of US-TPVB at T10-T11 level was performed with 20 mL of 0.25% ropivacaine. The quality of anesthesia, visual analogue scale of pain, and venous total plasma ropivacaine level were compared between the 2 groups. Results: Seventy-four eligible patients were enrolled and 38 in Group TPVB. Thirty patients in Group TPVB and 26 patients in Group LAI underwent PDC procedures successfully. Higher satisfaction rates by nephrologists and patients (76.3 and 78.9%) were reported in Group TPVB (44.4 and 44.4% in Group LAI, respectively). The peak venous total plasma ropivacaine concentrations were below the reported toxic threshold in the 2 groups. Conclusions: A single-injection US-TPVB with 20 mL of 0.25% ropivacaine at T10-T11 could be the principal anesthetic technique for PDC procedures, which provided a comparable anesthetic effect to that of LAI with 40 mL ropivacaine. Higher satisfaction rates by nephrologists and patients were observed in Group TPVB. The 20 mL dose of 0.25% ropivacaine used for an US-TPVB was safe in endstage renal diseases patients.

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“…GA may have inhibitory effects on cardiopulmonary function [8], and the use of GA in patients with ESRD may put them at risk [9]. Our previous observation has also shown that GA is one of the risk factors for all-cause unexpected hospitalization after PDC implantation [10]. It was reported that PDC implantations could also be performed by laparoscopy under LAI with nitrous oxide for pneumoperitoneum [11], but this technique was not widely used.…”

Section: Introductionmentioning

confidence: 99%

A Randomized Controlled Trial of Comparing Ultrasound-Guided Transversus Abdominis Plane Block with Local Anesthetic Infiltration in Peritoneal Dialysis Catheter Implantation

Tang²,

Tao³

et al. 2017

Blood Purif

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Background: The ultrasound-guided transversus abdominis plane (TAP) block has been demonstrated as a useful analgesia technique in lower-abdomen surgeries. We hypothesized that it could be the principal anesthesia technique for end-stage renal disease (ESRD) patients undergoing peritoneal dialysis (PD) catheter (PDC) implantation using the open dissection method. Methods: This was a single-center, prospective, randomized, and double-blinded study. All eligible patients were randomized into 2 groups: the TAP block group (n = 20) and the local anesthetic infiltration (LAI) group (n = 20). Results: Compared with the LAI group, the TAP block group revealed a remarkably lower visual analogue score, lower switching rate into general anesthesia, higher satisfaction rate, and less rescuing analgesic consumption during operation (p < 0.05). Both PD- and anesthesia-related complications were rare in the 4-week follow-up. Conclusions: The ultrasound-guided TAP block had better analgesic effect than LAI and can be used as a principal anesthesia technique for PDC implantation in ESRD patients without previous abdominal surgery.

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Analysis of Hospitalization after Peritoneal Dialysis Catheter Implantation

Cited by 8 publications

References 24 publications

Prevalence, risk factors and impact on outcomes of 30-day unexpected rehospitalization in incident peritoneal dialysis patients

Prevalence, risk factors and impact on outcomes of 30-day unexpected rehospitalization in incident peritoneal dialysis patients

Single-Injection Ultrasound-Guided Thoracic Paravertebral Block versus Local Anesthetic Infiltration in Peritoneal Dialysis Catheter Surgeries: A Randomized Controlled Trial

A Randomized Controlled Trial of Comparing Ultrasound-Guided Transversus Abdominis Plane Block with Local Anesthetic Infiltration in Peritoneal Dialysis Catheter Implantation

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