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Laparoscopic-Assisted Seldinger Technique for Peritoneal Dialysis Catheter Insertion
Published on: May 23, 2025
Surgical complications after peritoneal dialysis catheter implantation depend on children's weight
Josephine Radtke1, Anja Lemke2, Markus J Kemper2
1Department of Hepatobiliary and Transplant Surgery, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany.
Insights
Children weighing less than 10kg have a higher risk of surgical complications after peritoneal dialysis (PD) catheter implantation. Careful consideration is needed for these young patients undergoing PD catheter placement.
Area of Science:
- Pediatric Surgery
- Nephrology
- Medical Devices
Background:
- Surgical complications following peritoneal dialysis (PD) catheter implantation can occur in up to 30%-40% of cases within the first 8 weeks.
- Identifying risk factors for PD catheter complications in pediatric patients is crucial for improving outcomes.
Purpose of the Study:
- To analyze the incidence of complications and surgical revisions in pediatric patients undergoing peritoneal dialysis (PD) catheter implantation.
- To determine if children's weight and diagnosis influence the rate of PD catheter complications.
Main Methods:
- Retrospective review of 70 PD catheters implanted in 61 children between 2009 and 2014.
- Analysis of complication and revision rates within 6 months post-implantation, stratified by patient weight and diagnosis.
Main Results:
- 24.3% of PD catheters (17 out of 70) required surgical revision within 6 months.
- Peritonitis (18.6%), obstruction (12.9%), and dislocation (10%) were the most frequent complications.
- Leakage occurred exclusively in children under 10kg, and overall complication rates were significantly higher in this weight group (P<0.001).
Conclusions:
- Peritoneal dialysis (PD) is a safe treatment option for children with acute renal failure and older children with chronic renal failure.
- Children weighing less than 10kg represent a higher-risk group for PD catheter-related complications, necessitating closer monitoring and potentially tailored surgical approaches.
Background:
Surgical complications are estimated to be as high as 30%-40% during the first 8 weeks after implantation of peritoneal dialysis (PD) catheters.
Methods:
70 PD catheters which were implanted by transplant surgeons in 61 children (median age 3.3years, range 0.01-15.5years, 31 boys and 30 girls) in 2009-2014 were retrospectively reviewed. The incidence of complications and revisions during the first 6months after implantation was analyzed depending on children's weight and diagnosis.
Results:
17 out of 70 catheters needed a surgical revision within 6months after implantation (24.3%). Peritonitis was the most common complication affecting 18.6% of peritoneal dialysis catheters followed by obstruction and dislocation, which it occurred in 9 (12.9%) and 7 (10%) catheters, respectively. Leakage (n=5) only occurred in children with a weight of less than 10kg. The total proportion of complications was higher in children with less than 10kg of weight (P<0.001).
Conclusion:
PD is safe in children with acute renal failure and older children with chronic renal failure; however children with a weight of less than 10kg are more likely to develop complications.
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