Abstract: FR-PO532
Complications in Peritoneal Dialysis Catheters Placed Percutaneously vs. Surgically in a Second Level Hospital in Merida, Mexico
Session Information
- Home Dialysis, Policy, Novel Approaches
November 04, 2022 | Location: Exhibit Hall, Orange County Convention Center‚ West Building
Abstract Time: 10:00 AM - 12:00 PM
Category: Dialysis
- 702 Dialysis: Home Dialysis and Peritoneal Dialysis
Authors
- Alvarez Zapata, Naomi Alejandra, Hospital General Agustin O'Horan, Merida, Yucatán, Mexico
- Tapia Silva, Leticia Mirell, Hospital General Agustin O'Horan, Merida, Yucatán, Mexico
Background
The state of Yucatan has the highest prevalence of obesity, diabetes and nephrolithiasis in Mexico. The Hospital Dr. Agustin O'Horan is located in Merida and receives uninsured patients of indigenous Mayan descent. Due to the limited access to healthcare in these regions and the high prevalence of comorbidities, most patients progress to renal failure and end up in the emergency department with uremic syndrome. The objective of our study is to describe the frequency of mechanical and infectious complications within 30 days of peritoneal dialysis (PD) catheter insertion between the percutaneous and surgical technique.
Methods
This is a descriptive study conducted at our hospital from January 1st to April 24th, 2022. Data was collected from patients who were candidates to start renal replacement therapy with PD. Percutaneous catheter insertion was performed with a bedside blind technique or with an open mini-laparotomy. Patient preparation in the percutaneous approach included fasting, insertion of a urinary catheter and colonic enema. Informed consent and preoperative blood tests were obtained. Analgesia and antibiotic prophylaxis were administered and double cuff Tenckhoff catheters were used.
Results
48 dialysis catheter insertions took place in 44 patients while 4 of them underwent catheter removal and replacement. The mean age of the participants was 49.9 years, 61.3% were women and 70.4% were diabetic. Of the total of PD catheter insertions, 18 were percutaneous and 30 surgical. There was no difference between groups in terms of mechanical and infectious complications, while transfer to hemodialysis was more common in the surgical group.
Conclusion
One of the greatest challenges that Mexico faces is the accelerated growth of chronic kidney disease in a vulnerable population with limited access to healthcare. Achieving safer, and more convenient PD catheter placement with the use of minimal human and material resources is key to our institution in order to reduce the cost and the impact of kidney failure.
| Variable | Percutaneous (n=18) | Surgical (n=30) | p |
| Mechanical dysfunction (%) | 2(11) | 8(26) | 0.16 |
| Exit-site infection (%) | 1(5.5) | 1(3.3) | 0.76 |
| Peritonitis (%) | 2(11) | 2(6.6) | 0.68 |
| Uncomplicated catheter within 30 days (%) | 13(72) | 15(50) | 0.13 |
| Transfer to hemodialysis (%) | 0(0) | 9(30) | 0.007 |