Use of the embedded peritoneal dialysis catheter

Area of Science:

• Nephrology
• Surgical Innovation
• Medical Device Performance

Background:

• Embedded peritoneal dialysis (PD) catheters offer potential benefits over standard placement.
• Optimal embedment duration and effects of prolonged embedment on PD catheter function are not well-established.
• Understanding these factors is crucial for improving PD outcomes.

Purpose of the Study:

• To investigate the impact of PD catheter embedment duration on post-externalization function.
• To identify predictors of catheter non-function and subsequent loss.
• To evaluate the overall efficacy and complication rates of embedded PD catheters.

Main Methods:

• Retrospective observational study of adult patients undergoing embedded PD catheter insertion.
• Analysis of patient and procedural factors, including embedment duration and catheter damage.
• Assessment of catheter function, utilization, reintervention, and complication rates post-externalization.

Main Results:

• A median embedment period of 39.4 weeks was observed, with 63.6% of catheters externalized.
• Only 53.2% of externalized catheters functioned initially; 63.6% of non-functioning ones were salvaged.
• Increasing embedment duration significantly predicted catheter non-function (aOR: 0.957, p=0.003), leading to high catheter loss rates.

Conclusions:

• Prolonged embedment of PD catheters is significantly associated with increased catheter dysfunction.
• Catheter dysfunction at externalization strongly predicts subsequent catheter loss.
• The findings led to the discontinuation of the embedded technique in the study unit.