Embedded Catheters: Minimizing Excessive Embedment Time and Futile Placement while Maintaining Procedure Benefits

Area of Science:

• Nephrology
• Urology
• Surgical Procedures

Background:

• Early embedding of peritoneal dialysis (PD) catheters can secure patient modality choice and reduce central venous catheter (CVC) use.
• However, this practice may lead to prolonged catheter embedment periods and non-beneficial placements.

Purpose of the Study:

• This study investigated outcomes of embedded catheters.
• The aim was to identify factors that minimize excessive embedment duration and futile placement while retaining the advantages of the procedure.

Main Methods:

• A retrospective analysis was conducted on clinical and laboratory data from 107 patients with embedded catheters.
• Patients' catheters were categorized as externalized, remaining embedded, or futilely placed.

Main Results:

• Eighty-four catheters were externalized after a median embedment of 9.4 months, with a 14.3% rate of flow dysfunction.
• Overall function post-laparoscopic revision was 98.8%. Futile placement occurred in 13.1% of cases.
• Estimated glomerular filtration rate (eGFR) and serum albumin were significantly associated with catheter embedment duration (r(2) = 0.44, p < 0.0001).

Conclusions:

• The timing for embedding peritoneal dialysis catheters should consider both eGFR and serum albumin levels.
• Optimizing embedment timing based on these parameters can reduce excessive waiting times and futile placements, ensuring the procedure's benefits are maintained.