Abstract: PUB205
A Retrospective Analysis of Peritoneal Dialysis Catheter Reinsertion over 11 Years
Session Information
Category: Dialysis
- 802 Dialysis: Home Dialysis and Peritoneal Dialysis
Authors
- Morganti, Emma C., Epsom and Saint Helier University Hospitals NHS Trust, Carshalton, Sutton, United Kingdom
- Sood, Bhrigu Raj, Epsom and Saint Helier University Hospitals NHS Trust, Carshalton, Sutton, United Kingdom
Background
Increasing peritoneal dialysis uptake is limited by the shortened treatment time on PD compared with in-centre HD. A transition from PD to HD is costly, and associated with morbidity and impaired quality of life. There are numerous reasons why a PD catheter may need to be removed, and there is significant variability in patients having opportunity to return to PD. We retrospectively analysed a sample of PD catheter insertions to assess impact of our practice to reduce permanent transfer to HD over 11 years in our renal unit.
Methods
A sample of 583 of 1061 PD catheter insertions from 01/01/2013 to 31/12/2023 in a renal unit were reviewed. Electronic databases were reviewed for catheter duration, removal reason, whether reinserted, interim management and duration of management where available.
Results
The 583 catheters reviewed related to 448 distinct patients. 21.4% remained in situ at the completion of follow up (31/12/2023). Of the removed, 45% were removed for reasons which would not warrant consideration of reinsertion (transplantation 14.4%, death 11.5%, failure of PD 9.4%, patient preference 9.4%, regain of native renal function 0.7%).
Of the 55% which were removed for reasons which could allow for potential reinsertion (infection, malposition, accidental removal, hernias or leak), 53.8% were reinserted. The percentage of patients having reinsertion of catheters varied across years from 43.5 to 72.7%.
Interim management for 83 of the reinserted catheters showed 8.4% had a catheter reinserted on the same day, 49% had no interim renal replacement therapy, and 42.2% had interim haemodialysis.
Conclusion
PD is often the preferred form of renal replacement therapy for many patients, but a significant proportion transfer to HD within 2 years of starting PD. Supporting appropriate patients to return to PD varies amongst units. In this sample 54% of catheters removed for an indication which did not preclude reinsertion were reinserted, allowing ongoing access for PD. There is little information available to compare this with practices from other units. This study is limited as it is only sample of the data, and it was difficult to delineate decisions processes around whether reinsertion was appropriate from the available records. Going forward, we would aim to review all PD catheter insertions and removals for the time period and analyse what variables impacted outcomes.