Peritoneal dialysis catheter removal at the time or after kidney transplantation: A multicenter cardinality-matched...

Evidence regarding the optimal timing of peritoneal dialysis catheter (PDC) removal in renal graft recipients is limited. While some centers opt for removal during the transplant procedure, others defer catheter removal to various time points post-transplantation.

In this multicenter cardinality-matched cohort study, we aimed to determine the optimal timing of PDC removal in patients undergoing kidney transplantation.

Data from 324 patients were collected across 5 centers. We compared patients who had catheters removed during renal transplant (the PDC-free group) with those who had them removed after the procedure (the PDC group), matched 1:2 by age, sex, body mass index (BMI), living, and extended criteria donor statuses. We evaluated: 1) the need for dialysis within 2 post-transplant months, 2) a composite endpoint of catheter-related infection, peritonitis and/or surgical site infection, and 3) the length of hospitalization.

After cardinality matching, the groups were well-balanced across all matching covariates. Postoperative dialysis was required in 14% of patients, with no statistically significant difference observed between the PDC-free and PDC groups (19% vs 12%; odds ratio (OR) = 1.94; 95% confidence interval (95% CI): 0.78-4.81; p = 0.152). Of the 14 patients in the PDC group who required dialysis postoperatively, only 3 were managed with peritoneal dialysis. No statistically significant difference was noted for the composite endpoint (8.6% vs 6.2%; OR = 0.74; 95% CI: 0.20-2.77; p = 0.656). Hospitalization was significantly longer in patients from the PDC group (median [interquartile range (IQR)]: 11 [9-15] vs 9 [7-12]; BM = -3.036; p = 0.003).

This study did not demonstrate any benefits associated with delaying PDC removal in renal graft recipients. On the contrary, postponing removal was linked to prolonged hospitalization.