Optimizing peritoneal dialysis initiation: A comparative cohort study of catheter placement methods for shortening break‐in periods

Author:

Chávez‐Chávez Hugo E.1,Hernández‐Paredes Elisa Naomi2,Cojuc‐Konigsberg Gabriel2ORCID,Vargas‐Rodríguez Cecilia1,Díaz‐Canchola Laura Margarita1,Vergara‐Zavala Octavio1,Fernández‐Venegas Alonso1,Acevedo‐Juárez Nadia Stephani1,Correa‐Rotter Ricardo2,Ramirez‐Sandoval Juan C.2ORCID

Affiliation:

1. Hospital General Regional 180, Instituto Mexicano del Seguro Social Guadalajara Jalisco Mexico

2. Department of Nephrology and Mineral Metabolism Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán Mexico City Mexico

Abstract

AbstractIntroductionPeritoneal dialysis (PD) guidelines recommend a 14‐day break‐in period after catheter placement, yet this period could be shortened with new insertion techniques.MethodsWe conducted a prospective cohort study to compare percutaneous vs. surgical catheter insertion in a newly established PD program. The break‐in period was intentionally shortened to <24 h to start PD almost immediately.ResultsWe included 223 subjects who underwent percutaneous (34%) or surgical (66%) catheter placement. Compared to the surgical group, the percutaneous group had a higher proportion of early dialysis initiation within 24 h (97% vs. 8%, p < 0.001), similar successful initiation rates (87% vs. 92%, p = 0.34), and shorter lengths of stay (12 [9–18] vs. 18 [14–22] days, p < 0.001). Percutaneous insertion increased the likelihood of successful PD initiation within 24 h (OR 74, 95% CI 31–182), without increasing major complications.ConclusionPercutaneous placement could represent a cost‐effective and efficient technique to shorten break‐in periods.

Publisher

Wiley

Subject

Nephrology,Hematology

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