Long-term success of percutaneously placed peritoneal dialysis catheters

Percutaneous peritoneal dialysis (PD) catheters demonstrate short-term outcomes comparable to surgically placed catheters but remain underutilized because of concerns regarding long-term durability and limited follow-up data. We retrospectively reviewed 117 PD catheters in 90 patients who initiated PD between 2014 and 2020 at a freestanding home dialysis unit, with follow-up through December 2022. Eighty-three catheters were placed percutaneously by interventionalists and 34 laparoscopically for suspected hernias, prior abdominal surgery, or refractory peritonitis. The primary outcome was catheter survival, defined as time from PD training initiation to PD discontinuation. Secondary outcomes included catheter-related adverse events not requiring removal. The mean age was 46.5 ± 14 years; 38% were female, 76% Hispanic, mean BMI was 30 ± 7 kg/m², and diabetes accounted for 63% of kidney failure cases. Baseline characteristics were similar between groups except for lower BMI in the percutaneous cohort. Median catheter longevity was 20.3 months (IQR 6.8-36.0) for percutaneous placement and 17.0 months (IQR 7.2-30.8) for surgical placement. PD-related infections were the leading cause of catheter removal in both groups, while the rates of major and minor mechanical complications were comparable. To our knowledge, this is among the largest contemporary real-world cohorts evaluating long-term outcomes of percutaneous PD catheters, with follow-up extending beyond 5 years, and it addresses an important evidence gap. Percutaneous PD catheters demonstrated long-term survival and complication rates comparable to those of surgically placed catheters. These findings support broader adoption of percutaneous catheter placement to facilitate timely PD initiation and patient-centered modality selection.