Surgical outcomes analysis of pediatric peritoneal dialysis catheter function in a rural region

Abstract

Purpose The purpose of this study was to analyze the experience with peritoneal dialysis (PD) at a high-volume, single center institution that supports a rural population. Methods From 2000 to 2010, 88 children (median age: 1.98 years, [range: 2 days–20.2 years]) received 134 PD catheters for the management of acute and chronic renal failure. The primary outcome of interest was the incidence of primary PD catheter failure (replacement or revision within 60 days). Operative technique, longitudinal outcomes, and time intervals to transplantation were analyzed. Results Median time to transplant from the institution of dialysis was 1.4 years [range: 0.3–6.4 years]. Primary catheter failure occurred in 24.6% of cases. Infants less than 6 months of age demonstrated an increased incidence of primary catheter failure (p =0.02). The operative technique for catheter placement was not associated with the incidence of primary failure. Postoperative complications included peritonitis (22.7%), omental plugging (11.9%), pericatheter drainage (9.0%), and exit site infection (3.0%). Conclusion Peritoneal dialysis provides a safe and effective renal replacement therapy for regional pediatric centers that serve a rural population. However, primary catheter failure rates remain high at 24.6%. The surgical technique for placement had no effect on this failure rate in our patient population. Infants less than 6 months of age are at increased risk for primary catheter failure and warrant intensive surveillance.

Laparoscopic versus open peritoneal dialysis catheter insertion for the management of pediatric acute kidney injury

“…When comparing our results with those of other reports examining these techniques in children [16][17][18][19][20], we find that our rates of catheter manipulation and infectious complications are similar. We are also consistent in the finding of similar outcomes with both techniques.…”

The Use of Acute Peritoneal Dialysis in Critically Ill Newborns

“…APD is an invasive procedure that can cause some complications [ 16 ]. The most common complications of this procedure are leakage around the catheter, catheter obstruction, peritonitis, and perforation [ 1 , 4 , 11 , 18 ]. With the introduction of Tenckhoff catheters, there has been a significant decrease in the complication-related death rate [ 19 ].…”

The effects of peritoneal dialysis catheter insertion using paramedian versus midline approach on Children

“…Aside from the type and approach of catheter insertion, the reported rate of complication in children is different in studies. Stone et al (19) reported that the most common complications were peritonitis, omental plugging, pericatheter drainage and exit site infection. Kim et al (20) evaluating the noninfectious complications of PD catheter insertion in children in 26 years, reported the common catheter-related complications to be outflow failure, leakage and hernia.…”