The PD catheter dilemma

McGregor, Tom

doi:10.5489/cuaj.15

Cited by 3 publications

(7 citation statements)

References 2 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In addition, the presence of a catheter posttransplant, although not absolutely necessary in some patients, may allow better control of volume and electrolyte problems. 7,11 In previous pediatric studies, the most frequent catheter use occurred in the first month after transplant. 8,12 Arbeiter and associates, in a study of 26 PD patients who had their PD catheters left in situ after renal transplant, showed that 12 patients (46%) required its use because of delayed graft function within the first month after transplant.…”

Section: Discussionmentioning

confidence: 93%

“…However, recent literature has recommended that decisions concerning removal of a PD catheter must be made according to the patient's condition. 6,7 Arbeiter and colleagues stated that the removal of a catheter should involve the classic costbenefit analyses. 8 The "cost" of removal is the requirement for catheter reinsertion if a catheter is Abbreviations: PD, peritoneal dialysis subsequently needed.…”

Section: Discussionmentioning

confidence: 99%

“…The potential benefits of removing the PD catheter at the time of surgery is the elimination of a second procedure, as well as to avoid the potential complications due to having a PD catheter (including infection, peritonitis, and fluid leakage from the incision). [6][7][8][9][10] Conversely, in case of delayed graft function, having a PD catheter in place postoperatively provides multiple benefits of use of the catheter, allowing the allograft to recover function. In addition, the presence of a catheter posttransplant, although not absolutely necessary in some patients, may allow better control of volume and electrolyte problems.…”

Section: Discussionmentioning

confidence: 99%

“…6 McGregor and associates reported that most transplant recipients already have a central line at the time of surgery for central venous pressure monitoring and drug administration, as in our center; therefore, this line can be used as a dialysis line. 7 In addition, the removal of the catheter at the time of renal transplant prevents complications that can be related to the PD catheter and eliminates the need for a second procedure. [6][7][8][9][10]13 In conclusion, we suggest that, when deciding catheter removal time, the clinical course of the patient should be taken into consideration.…”

Section: Discussionmentioning

confidence: 99%

“…7 In addition, the removal of the catheter at the time of renal transplant prevents complications that can be related to the PD catheter and eliminates the need for a second procedure. [6][7][8][9][10]13 In conclusion, we suggest that, when deciding catheter removal time, the clinical course of the patient should be taken into consideration. For example, if a patient has little to no risk of developing a delayed graft function, the PD catheter can be removed at the time of transplant.…”

Section: Discussionmentioning

confidence: 99%

See 4 more Smart Citations

Untitled

2016

Exp Clin Transplant

View full text Add to dashboard Cite

Objectives: Peritoneal dialysis, the preferred long-term renal replacement modality in the pediatric population, can also be used during the post transplant period. Although it is well known that peritonitis or other complications may occur related to the peritoneal dialysis catheter, less is known about complications related to the peritoneal dialysis during the posttransplant period. Our objective was to evaluate the complications related to use of a peritoneal dialysis catheter during the posttransplant period and to determine the optimum time for removal of the peritoneal dialysis catheter. Material and Methods: We retrospectively analyzed 33 chronic peritoneal dialysis patients. Pretransplant and posttransplant demographics and clinical and laboratory data for each patient were recorded, including incidence of peritonitis and incidence of peritoneal dialysis catheter requirement after transplant. Results: Mean age of patients at transplant was 12.8 ± 4.0 years (range, 3.5-18.0 y). Mean catheter removal time was 81.1 ± 36.2 days (range, 22.0-152.0 d). The peritoneal dialysis catheter was used in 6 of 33 patients (18.2%); none of these patients developed peritonitis. In contrast, 2 of the 27 patients who did not use the peritoneal dialysis catheter developed peritonitis. Our data suggest that the need for catheter use occurs predominantly during the first month, and infectious complications usually happen later. Conclusions: Previously, the trend was to not remove the peritoneal dialysis catheter at the time of transplant. However, in light of recent literature and our present study, we recommend that the time of catheter removal should be modified and decided for each patient on an individual basis.

show abstract

Section: Discussionmentioning

confidence: 93%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 3 more Smart Citations

Untitled

2016

Exp Clin Transplant

View full text Add to dashboard Cite

show abstract

Quando è meglio rimuovere il catetere peritoneale dopo trapianto renale?

d’Adamo

2013

G Clin Nefrol Dial

View full text Add to dashboard Cite

Il dibattito sull'opportunità o meno di rimuovere il catetere peritoneale all'atto del trapianto renale è ancora aperto. Il mantenimento in sede del catetere viene infatti raccomandato dalle linee guida europee del 2005 per consentire la ripresa della dialisi peritoneale in caso di ritardata ripresa funzionale del rene trapiantato. Alcuni Centri Trapianto hanno però recentemente segnalato un alto tasso di complicanze post-trapianto connesse con la presenza del catetere, anche se non utilizzato, e suggeriscono di rimuoverlo al momento del trapianto per abbattere il rischio di complicanze e/o fallimento della DP ed evitare una seconda procedura a breve distanza dal trapianto.

show abstract

Peritoneal dialysis catheter removal at the time of renal transplantation: Choosing the optimal candidate

Kwong

Kroczak

Honey

et al. 2019

CUAJ

View full text Add to dashboard Cite

Introduction: Concurrent peritoneal dialysis (PD) catheter removal during renal transplantation is controversial, with limited evidence supporting this practice. Our objective was to determine the rate of delayed graft function (DGF) in patients on preoperative PD. Additionally, we sought to identify which patients can safely have their PD catheter removed during transplantation due to a low risk of DGF. Methods: We conducted a retrospective observational study between June 2011 and December 2015. The primary outcome was the diagnosis of DGF, defined as the need for dialysis within the first week of transplantation. Clinical and transplant factors, including graft type and donor criteria, were assessed for association with the primary outcome. Catheter-related complication rates were also compared between post-transplant PD and hemodialysis (HD). Results: Of our cohort of 567 patients, 145 patients (25.6%) developed DGF. Obesity (odds ratio [OR] 1.06; 95% confidence interval [CI] 1.00–1.11; p=0.04) and increased perioperative blood loss (OR 1.002; 95% CI 1.000–1.003; p=0.03) were predictors of DGF. Protective factors included living donor (LD) grafts (OR 0.15; 95% CI 0.05–0.49; p=0.002) and intraoperative graft urine production (OR 0.39; 95% CI 0.23–0.65; p<0.001). In our PD cohort, only LD grafts demonstrated lower DGF rates (0 LD vs. 20.8% deceased donor; p=0.003). In terms of post-transplant renal replacement therapy, patients on PD and HD had similar duration of temporary dialysis (one day PD vs. two days HD; p=0.48) and catheter-related complication rates (4.5% PD vs. 2.6% HD; p=0.30). Conclusions: Carefully selected patients, such as those receiving LD grafts, may benefit from concurrent PD catheter removal.

show abstract

The PD catheter dilemma

Cited by 3 publications

References 2 publications

Untitled

Untitled

Quando è meglio rimuovere il catetere peritoneale dopo trapianto renale?

Peritoneal dialysis catheter removal at the time of renal transplantation: Choosing the optimal candidate

Contact Info

Product

Resources

About