Catheter Event Rates in Medical Compared to Surgical Peritoneal Dialysis Catheter Insertion

Area of Science:

• Nephrology
• Surgical Innovation
• Patient Outcomes

Background:

• Peritoneal dialysis (PD) catheter insertion pathways require understanding of patient, center, and technique interactions.
• Optimizing PD catheter insertion is key to minimizing complications and improving patient adherence.

Purpose of the Study:

• To investigate the associations between patient and dialysis unit characteristics, catheter insertion techniques, and the occurrence of catheter-related events in the first year post-insertion.
• To compare the rates of catheter events between medical and surgical insertion methods using a multistate model.

Main Methods:

• Prospective cohort study in 44 UK centers involving 784 first-time PD catheter insertions.
• Regression analyses to identify factors associated with insertion technique and catheter events.
• Multistate modeling to compare event rates between medical and surgical insertions, considering treatment transitions and mortality.

Main Results:

• 59% of participants experienced a catheter event within the first year.
• Surgical insertions had less malfunction but more infection compared to medical insertions.
• Lower catheter event probability was observed in centers with fewer late presenters and more new PD patients.

Conclusions:

• Offering both medical and surgical PD catheter insertion techniques is associated with reduced catheter event rates.
• These techniques contribute to longer patient retention on peritoneal dialysis.