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Peritoneal Dialysis of Three-Cuff Catheter Experience in Qassim Province, Saudi Arabia
Ahmed AlSalloom1, Chandra Sekhar Kalevaru2, Kholoud Alomeri1
1King Fahd Specialist Hospital Buraidah, Buraydah, Al Qassim, Saudi Arabia.
Insights
Three-cuff peritoneal dialysis (PD) catheters show fewer complications and longer therapy duration compared to older models. This study highlights their benefits for patients with chronic kidney disease (CKD).
Area of Science:
- Nephrology
- Medical Devices
- Surgical Procedures
Background:
- Global increase in noncommunicable diseases, including chronic kidney diseases (CKDs), necessitates advanced dialysis solutions.
- Shift from two-cuff to three-cuff catheters in peritoneal dialysis (PD) is expanding in Saudi Arabia's nephrology centers.
Purpose of the Study:
- To evaluate the benefits, complications, and therapy duration of three-cuff PD catheters.
- To assess the efficacy of omentopexy in conjunction with three-cuff PD catheter insertion.
Main Methods:
- Cross-sectional study of 257 patients undergoing three-cuff PD catheter insertion and omentopexy.
- Retrospective data collection from 2016-2023 at King Fahad Specialist Hospital, Buraidah.
- Statistical analysis using SPSS, including descriptive statistics, chi-square test, and logistic regression.
Main Results:
- Average therapy duration was 27.84 months.
- Minimal early complications: 5.1% peritonitis, 0.8% catheter migration, 0.4% omental wrap, 0.4% exit site infection.
- Low rates of catheter reinsertion (7.8%) and removal due to catheter-related issues (3.8%).
Conclusions:
- Three-cuff catheters demonstrate fewer complications, superior performance, and longer therapy duration in PD patients.
- Outcomes attributed to catheter design, staff dedication, and strict policies.
- Recommendations for long-term supportive measures by health authorities to sustain positive results.
Abstract:
Background: The global rise in noncommunicable diseases, including chronic kidney diseases (CKDs), has led to a significant increase in the use of dialysis units to enhance patient longevity and quality of life. Over time, two-cuff catheters have been replaced by three-cuff catheters, with their usage expanding in nephrology centers across Saudi Arabia. This study aimed to evaluate the benefits, complications, and duration of therapy associated with three-cuff catheters in peritoneal dialysis (PD) patients. Methodology: To ensure the reliability of our results, we conducted a comprehensive cross-sectional study involving 257 patients who underwent three-cuff PD catheter (PDC) insertion and omentopexy. Data were retrospectively collected from 2016 to 2023 at King Fahad Specialist Hospital, Buraidah. The questionnaire was designed based on available variables in the records section and validated by subject experts and experienced research faculty. Data were then entered and analyzed using SPSS version 21.0. Descriptive statistics were employed for inferential statistics, while the chi-square test and logistic regression analysis were used to identify predictors of PD outcomes. Results: The average duration of therapy was 27.84 months, with a standard deviation of 27.23 months. Early complications were minimal, with just 5.1% (n = 13) experiencing peritonitis, 0.8% (n = 2) facing catheter migration, and 0.4% (n = 1 each) encountering omental wrap and exit site infection (ESI) within 30 days of catheter insertion. Remarkably, only 7.8% (n = 20) required catheter reinsertion. In addition, catheter removal due to catheter-related issues was low, affecting only 3.8% of patients. Conclusions: According to the study findings, three-cuff catheters exhibited fewer complications, superior performance, and longer therapy duration. These outcomes may be attributed to the thorough design of the three-cuff catheters, the dedication of the staff, and the implementation of strict policies. To maintain these positive results, it is crucial for the Ministry of Health and the Health Cluster to adopt long-term supportive measures.
