740 results on '"Peritoneal dialysis catheter"'
Search Results
2. The efficacy of cuff-shaving combined with negative pressure wound therapy in refractory exit-site and tunnel infections: a single center experience
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Qinghua Yang, Xiaoying Ren, Xiaowan Fang, and Jiaxiang Ding
- Subjects
Negative pressure wound therapy ,Peritoneal dialysis catheter ,Refractory exit-site infection ,Superficial cuff-shaving ,Tunnel infection ,Diseases of the genitourinary system. Urology ,RC870-923 - Abstract
Abstract Background Refractory exit-site infections (ESIs) and tunnel infections (TIs) are challenging complications for patients undergoing peritoneal dialysis (PD). This study compared the outcomes of surgical intervention, notably the cuff-shaving (CS) procedure coupled with negative-pressure wound therapy (NPWT), and conservative management strategies for patients with refractory ESI and TI. Methods We retrospectively reviewed patients who underwent PD at our center, focusing on the incidence and management of ESI and TI. We evaluated and compared treatment outcomes, including ESI scores, frequency of ESI and/or TI, identification of causative microorganisms, and duration of catheter survival or time until removal. Results We identified 97 episodes of catheter-related ESI and/or TI across 71 patients with an incidence rate of 0.15 episodes per patient-year. Of the 23 patients with refractory ESI and/or TI, surgical intervention was performed in 8, while 15 chose conservative management. In the one-month follow-up, patients who underwent CS combined with NPWT showed no complications such as leakage, and their local symptoms resolved completely. The mean PD catheter survival time was significantly longer in the surgical group (29.38 ± 7.25 months) than in the conservative group (7.86 ± 2.13 months). Surgical intervention demonstrated a significantly higher therapeutic efficacy and extended catheter survival. Conclusions The combination of CS and NPWT as a surgical approach is crucial for eradicating infectious foci and significantly improving the longevity of PD catheter function. This integrated surgical strategy offers a promising solution for the management of refractory ESI and TI in patients undergoing PD.
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- 2024
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3. The efficacy of cuff-shaving combined with negative pressure wound therapy in refractory exit-site and tunnel infections: a single center experience.
- Author
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Yang, Qinghua, Ren, Xiaoying, Fang, Xiaowan, and Ding, Jiaxiang
- Subjects
DIALYSIS catheters ,TREATMENT effectiveness ,NEGATIVE-pressure wound therapy ,PERITONEAL dialysis ,CATHETERS ,REFRACTORY materials - Abstract
Background: Refractory exit-site infections (ESIs) and tunnel infections (TIs) are challenging complications for patients undergoing peritoneal dialysis (PD). This study compared the outcomes of surgical intervention, notably the cuff-shaving (CS) procedure coupled with negative-pressure wound therapy (NPWT), and conservative management strategies for patients with refractory ESI and TI. Methods: We retrospectively reviewed patients who underwent PD at our center, focusing on the incidence and management of ESI and TI. We evaluated and compared treatment outcomes, including ESI scores, frequency of ESI and/or TI, identification of causative microorganisms, and duration of catheter survival or time until removal. Results: We identified 97 episodes of catheter-related ESI and/or TI across 71 patients with an incidence rate of 0.15 episodes per patient-year. Of the 23 patients with refractory ESI and/or TI, surgical intervention was performed in 8, while 15 chose conservative management. In the one-month follow-up, patients who underwent CS combined with NPWT showed no complications such as leakage, and their local symptoms resolved completely. The mean PD catheter survival time was significantly longer in the surgical group (29.38 ± 7.25 months) than in the conservative group (7.86 ± 2.13 months). Surgical intervention demonstrated a significantly higher therapeutic efficacy and extended catheter survival. Conclusions: The combination of CS and NPWT as a surgical approach is crucial for eradicating infectious foci and significantly improving the longevity of PD catheter function. This integrated surgical strategy offers a promising solution for the management of refractory ESI and TI in patients undergoing PD. [ABSTRACT FROM AUTHOR]
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- 2024
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4. Risk factors, management and outcomes for peritoneal dialysis access damage
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Ruoxi Liao, Xueli Zhou, Xia Liu, Xueqin He, Li Pu, Dengyan Ma, and Hui Zhong
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Peritoneal dialysis ,peritoneal dialysis catheter ,risk factor ,management ,outcome ,Diseases of the genitourinary system. Urology ,RC870-923 - Abstract
Objectives: Peritoneal dialysis (PD) access damage is an uncommon complication of PD. This study aimed to describe the characteristics, management and outcomes of PD access damage.Methods: This retrospective study included patients who suffered from PD access damage between January 2018 and January 2024 at the PD Center of West China Hospital. Patient characteristics and access damage information were collected from medical records.Results: A total of 128 PD patients without PD access damage were included in the control group. A total of 45 patients (51% male; aged 58 ± 14 years) suffered from 49 cases of PD access damage. Multivariate logistic analysis revealed that previous peritonitis [odds ratio (OR) 3.93; 95% confidence interval (CI) 1.56 to 9.94] and assisted PD (OR 4.20; 95% CI 1.25 to 14.12) were risk factors, while catheter belt use (OR 0.16; 95% CI 0.06 to 0.44) and training frequency per year (0.34; 95% CI 0.19 to 0.64) were protective factors against PD access damage. Managements included cutting and repairing (N = 24), transfer set replacement (N = 11), catheter removal (N = 9) and catheter replacement (N = 4). Thirty-nine patients continued with PD after access repair and were followed up for a median of 35 months. The repaired access functioned well during follow-up.Conclusions: In conclusion, to avoid PD access damage, catheter belt and routine retraining are recommended. Once PD access damage is identified, patients should clamp the catheter, take prophylactic antibiotics and resort to the treatment team. The treatment team should evaluate PD access and handle it according to a clinical protocol.
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- 2024
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5. History of Dialysis and Dialysis Access
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Abreo, Kenneth, Baker, Atlee, Morisetti, Phani, Abreo, Adrian, Illig, Karl A., editor, Scher, Larry A., editor, and Ross, John R., editor
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- 2024
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6. A perspective on integrated dialysis access management: in advance of integrated care plan
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Beatriz Gil Braga, Joana Tavares, and Maria João Carvalho
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peritoneal dialysis ,Hemodialysis vascular access ,Hemodialysis ,Daily home hemodialysis ,peritoneal dialysis catheter ,Internal medicine ,RC31-1245 - Abstract
(To read the full article, in English or French, click on the pdf logo on the right). We would like to draw attention to the critical issue of dialysis access management and vascular access (VA) options in patients transitioning to chronic renal replacement therapy and from peritoneal dialysis (PD) to hemodialysis (HD). We advocate for the establishment of dedicated consultation services for integrated dialysis access management to optimize patient outcomes. We highlight specific cases where a tailored approach to VA selection is essential, emphasizing the importance of risk stratification and timely access preparation. The preferred use of arteriovenous fistula in HD patients and the challenges surrounding its maturation are discussed. We also explore circumstances necessitating urgent versus planned transitions to HD, incorporating considerations for patient-centered care and education. Sonography’s role in managing PD-related infections and the potential benefits of home HD in the transition process are also examined. We suggest the development of scoring systems to predict patient transitions and emphasize the need for an integrated approach to dialysis access management. Overall, we advocate for proactive measures to prevent vascular access failure and ensure a safe and effective transition process for patients with chronic kidney disease.
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- 2024
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7. Analysis of Peritoneal Dialysis Catheters Placed via Surgical Method: Single-Center Experience.
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Karaagac, Mustafa, Carkit, Sedat, Uysal, Cihan, Talih, Tutkun, Kocyigit, İsmail, and Sozuer, Erdogan Mutevelli
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PERITONEAL dialysis , *DIALYSIS catheters , *CHRONIC kidney failure , *RENAL replacement therapy , *BODY mass index , *ULTRAFILTRATION - Abstract
Objective: Peritoneal dialysis is a widely used renal replacement therapy for end-stage renal disease (ESRD). This study aims to evaluate the duration of use and complications associated with peritoneal dialysis catheters (PDC) placed using an open surgical method in a singlecenter experience. Materials and Methods: This study included 127 ESRD patients who underwent PDC placement between 2018 and 2023. We analyzed the patients' clinical and demographic data, the reasons for transitioning to hemodialysis, and the complications leading to this transition. Patients with a body mass index (BMI) of 30 or higher were considered obese, and the impact of this condition on complications was specifically investigated. The PDC placement using the open surgical method was performed by the same surgical team. Results: Of the 127 patients who had PDCs placed in the last five years, approximately 55.1% experienced various complications, leading to a transition to hemodialysis in 31 patients. Reasons for switching included catheter-related problems (35.4%), peritonitis (25.8%), ultrafiltration failure (19.3%), dialysis inadequacy (6.4%), and hernia (3.2%). No significant change in the overall risk of complications was observed in patients with a BMI of 30 or higher; however, a significant increase in the risk of peritonitis was noted in these patients. Conclusion: The open surgical method is a preferred technique for PDC placement due to its ease of application and low complication rates. Notably, in patients with a BMI of 30 or higher, an increase in infection-related complications, such as peritonitis, was observed. Therefore, greater attention should be devoted to managing infection-related complications in the use of PDCs among obese patients. [ABSTRACT FROM AUTHOR]
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- 2024
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8. Efficacy and safety of removing peritoneal dialysis catheters using the pull technique.
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Zhang, Lina, Ma, Xu, Zheng, Yanping, Tian, Suge, Zhang, Jing, Yan, Lei, Gu, Yue, and Shao, Fengmin
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Purpose: To study the efficacy and safety of peritoneal dialysis (PD) catheter removal using the pull technique. Methods: We conducted a retrospective analysis of 36 patients in whom the pull technique was used to remove a PD catheter. We evaluated the efficacy, safety, and health economic benefits of this technique by analyzing the pain score, duration of the procedure, complications during or after the procedure, and cost. Results: The mean age (± standard deviation) of the 36 patients was 51 ± 14 years involving 27 males and 9 females with a mean body mass index was 23.4 ± 2.6. The mean duration of PD was 28 months (range 4–96 months). The site of the pull technique for peritoneal dialysis catheter removal was at the bedside or in the treatment room, with local anesthesia or no anesthesia. The mean duration of the procedure (from anesthesia to complete removal of the PD catheter) was 5–15 min. Only one patient experienced catheter rupture and no patients developed procedural or post-procedural bleeding or abdominal wall leakage. Infection did not occur at the inner or outer cuffs, tunnel, or outlet. Pain scores analyzed by a 10-point visual analogue scoring technique both immediately and 24 h after the procedure were 3.5 ± 1.7 and 1.2 ± 0.8, respectively. Conclusions: The pull technique is simple to perform, takes a short time, results in few complications and small wounds, causes only mild pain, enables fast recovery, and results in low medical costs. [ABSTRACT FROM AUTHOR]
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- 2024
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9. Nephroscope-assisted single trocar peritoneal dialysis catheter insertion improves catheter survival compared with laparoscopic technique: Ten-year experience of a single-center.
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Yang, Han-Chung, Hsieh, Hsiang-Chen, Liao, Po-Chi, Chang, Li-Wen, Hu, Ju-Chuan, Hung, Sheng-Chun, Lin, Chia-Yen, Wang, Shu-Chi, Chen, Cheng-Che, Yang, Cheng-Kuang, Wang, Shian-Shiang, Chen, Chuan-Shu, Lu, Kevin, Li, Jian-Ri, Cheng, Chen-Li, and Chiu, Kun-Yuan
- Abstract
An ideal technique for peritoneal dialysis (PD) catheter insertion should provide a long-term functioning catheter until permanent renal replacement therapy becomes available. We developed a technique using the nephroscope-assisted single-trocar approach in 2011. In this study, we report the outcomes, learning curve analysis and cost-effectiveness analysisof the nephroscopic approach compared with the traditional laparoscopic approach. Between January 2005 and December 2020, we retrospectively reviewed 511 patients who received PD catheter insertions using the laparoscopic or nephroscopic approach. We compared the baseline characteristics of the patients, surgical outcomes, and complications of the two groups. We further analyzed the nephroscopic group to determine the cost-effectiveness analysis, learning curve and the complication frequency between the learning and mastery periods of the nephroscopic approach. A total of 208 patients underwent laparoscopic PD catheter insertion, whereas 303 patients received nephroscopic surgery. The median catheter survival in the nephroscopic group is significantly longer (43.1 vs. 60.5 months, p = 0.019). The incidence of peritonitis (29.3% vs.20.8%, p = 0.035) and exit site infection (12.5% vs. 6.6%, p = 0.019) were significantly lower in the nephroscopic group. The cost-effectiveness analysis showed a medical expense reduction of 16000 USD annually by using the nephroscopic technique. There was no difference in the frequency of surgical complications between the learning and mastery phases when examining the learning curve analysis for the nephroscopic technique. Compared with the traditional laparoscopic approach, the nephroscopic technique effectively prolonged catheter survival and reduces health care cost by reducing infectious complications. The low complication rate during the learning phase of surgery makes the procedure safe for patients and surgeons. [ABSTRACT FROM AUTHOR]
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- 2024
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10. Peritoneal Dialysis Access and Exit-Site Care Including Surgical Aspects
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Kathuria, P., Twardowski, Z. J., Nichols, W. K., Khanna, Ramesh, editor, and Krediet, Raymond T., editor
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- 2023
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11. Analysis of the impact of peritoneal dialysis catheter tail‐end design on catheter‐related complications.
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Zou, Hong‐chang, Gao, Ming‐ming, Chen, Yan‐xia, Xu, Cheng‐yun, Tu, Wei‐ping, and Qin, Xiao‐hua
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PERITONEAL dialysis ,FACTOR analysis ,CATHETERS ,DIALYSIS catheters - Abstract
Objective: Evaluate the impact of peritoneal dialysis catheter (PDC) tail‐end design variations on PDC‐related complications. Method: Effective data were extracted from databases. The literature was evaluated according to the Cochrane Handbook for Systematic Reviews of Interventions, and a meta‐analysis was conducted. Results: Analysis revealed that the straight‐tailed catheter was superior to the curled‐tailed catheter in minimizing catheter displacement and complication‐induced catheter removal (RR = 1.73, 95%CI:1.18–2.53, p = 0.005). In terms of complication‐induced PDC removal, the straight‐tailed catheter was superior to the curled‐tailed catheter (RR = 1.55, 95%CI: 1.15–2.08, p = 0.004). Conclusion: Curled‐tail design of the catheter increased the risk of catheter displacement and complication‐induced catheter removal, whereas the straight‐tailed catheter was superior to the curled‐tailed catheter in terms of reducing catheter displacement and complication‐induced catheter removal. However, the analysis and comparison of factors such as leakage, peritonitis, exit‐site infection, and tunnel infection did not reveal a statistically significant difference between the two designs. [ABSTRACT FROM AUTHOR]
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- 2023
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12. Peritoneal Dialysis in a Low-Resource Setting
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Alao, Michael A., Palmer, Dennis, Njini, Norah Ndi Nyah, Ibrahim, Olayinka R., Slusher, Tina M., editor, Bjorklund, Ashley R., editor, and Lauden, Stephanie M., editor
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- 2022
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13. Outcomes of Percutaneous Peritoneal Dialysis Catheters Insertion by Interventional Radiologists: A Single-Institution Experience
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Khadijah Alhussaini, Shaima Abulqasim, Abdulaziz Mohammad Al-Sharydah, Elwaleed Elhassan, and Mohammad Arabi
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interventional radiology ,image-guided interventions ,percutaneous catheter insertion ,peritoneal dialysis catheter ,peritoneal dialysis ,Medical physics. Medical radiology. Nuclear medicine ,R895-920 - Abstract
Objectives This article evaluates the short- and long-term outcomes of percutaneous peritoneal dialysis (PD) catheters inserted by interventional radiology service and analyzes the factors that affect the sustainability of patent and functional PD catheters. Materials and Methods Retrospective single-institution study between April 2015 and February 2021. A total of 131 patients (75 males) were enrolled with mean age of 50 ± 19.6 years with an average body mass index (BMI) of 28 ± 7 kg/m2. Technical and clinical success were evaluated. Catheter-related complications were classified into mechanical and nonmechanical categories, including infectious complications. Indications for removal were analyzed. Results Technical and clinical success were 100%. The average dwelling time for the entire cohort was 497.5 ± 462.3 days. Forty-six patients (35%) were on PD at the last follow-up with an average dwelling time of 492 days. PD-related complications were reported in 79/131 (60.3%) patients, including peritonitis (40.46%; 53/131), followed by malposition/migration (12.21%; 16/131), tunnel/exit site infection (10.69%; 14/131), and dysfunction (12.21%; 16/131). The incidence of peritonitis within 30 days postinsertion was 9.43% (5/53). The average interval between insertion and migration was 100.5 ± 144.8 days (95% confidence interval, 6.9–14.4). There was a trend for a higher rate of malposition/migration in patients with higher BMI (p = 0.0561). Causes for PD catheters removal were: (1) infection-related (24.4%; 32/131), (2) renal transplant recipients (16%; 21/131), (3) mechanical complications (13.7%; 18/131), and (4) patient's preference (7.6%; 10/131). Conclusion Percutaneous PD catheter placement by interventional radiologists provides acceptable long-term outcomes and complication rates that meet the recommended standards.
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- 2022
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14. Inferior epigastric artery injury after percutaneous imaging-guided peritoneal dialysis catheter placement
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Emily A Dryer, DO, Masa Abaza, BS, and Ammar Almehmi, MD
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Peritoneal dialysis catheter ,Embolization ,Inferior epigastric artery ,Iatrogenic arterial injury ,Hemoperitoneum ,Imaging Guidance ,Medical physics. Medical radiology. Nuclear medicine ,R895-920 - Abstract
Inferior epigastric artery (IEA) injury is a rare clinical entity that is usually associated with abdominal wall procedures and injuries though can also be spontaneous, particularly in individuals with coagulopathy. Of all described mechanisms of injury, percutaneous peritoneal dialysis (PD) catheter insertion is a rarely encountered, particularly in instances where insertion is performed under imaging guidance. While this injury is self-limited, it can be associated with hemodynamic instability and acute blood loss anemia, which can be fatal if left untreated. Computed tomographic (CT) angiography is the diagnostic method of choice. Transcatheter arterial embolization is an effective treatment modality with a high success rate. Here, we describe a 41-year-old female who underwent percutaneous PD catheter insertion that, despite intraprocedural imaging guidance, was complicated by large hemoperitoneum and clinical instability. Prompt identification of IEA injury followed by immediate intervention with coil embolization led to a successful outcome for this patient in the setting of a life-threatening uncommon complication of such procedure. The details of the diagnostic evaluation and management are outlined.
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- 2022
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15. Peritoneal dialysis catheter removal at the time or after kidney transplantation: a systematic review and meta-analysis.
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Zawistowski, Michał, Nowaczyk, Joanna, and Domagała, Piotr
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PERITONEAL dialysis , *DIALYSIS catheters , *KIDNEY transplantation , *CATHETER-related infections , *RANDOMIZED controlled trials - Abstract
Purpose: An increasing number of patients treated with peritoneal dialysis eventually undergo kidney transplantation. Owing to opposing reports, we aimed to find evidence about the best time for peritoneal dialysis catheter removal in transplant patients. Methods: We conducted a systematic review and random effects meta-analysis of non-randomized studies of intervention comparing patients with peritoneal dialysis catheters left in place or removed during kidney transplantation in regard to the need for dialysis and occurrence of catheter-related complications. We searched (last update on 8 December 2021) PubMed, Embase, Scopus, and Web of Science for eligible studies. ROBINS-I tool and funnel plot asymmetry analysis were used to assess the quality of included articles. Results: Eight observational studies were evaluated. Five of them, which involved 338 patients, were included in a meta-analysis. All were at moderate to serious risk of bias. The odds of needing dialysis are more than twice as high for patients with peritoneal dialysis catheters left in situ (pooled odds ratio, 2.21; 95% confidence interval [CI], 1.03 to 4.73; I2 = 0%). No statistically significant difference was noted when adult and pediatric subgroups were compared (Q = 0.13, P =.720). More individuals with catheters left in place required dialysis (pooled prevalence, 20.9%; 95% CI, 13.6 to 30.7%; I2 = 59% vs. 12.4%; 95% CI, 5.6 to 25.2%; I2 = 0%) and experienced catheter-related infections. Conclusion: Available evidence is scarce. Unless new data from a randomized controlled trial are available, the dilemma of peritoneal dialysis catheter removal cannot be solved. Trial registration: PROSPERO Protocol ID: CRD42020207707. [ABSTRACT FROM AUTHOR]
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- 2022
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16. Infectious Complications in Peritoneal Dialysis
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Saxena, Anjali Bhatt, Rastogi, Anjay, editor, Lerma, Edgar V., editor, and Bargman, Joanne M., editor
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- 2021
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17. Percutaneous endoscopic gastrostomy in children: A tertiary center experience.
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Bawazir, Osama, Banaja, Abdulaziz M, Bawazir, Razan, and Bawazir, Abdullah Osama
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PERITONEAL dialysis , *PERCUTANEOUS endoscopic gastrostomy , *CHILD patients , *CARDIAC patients , *SURGICAL complications , *MEDICAL device removal , *HEART diseases - Abstract
Introduction: Percutaneous endoscopic gastrostomy (PEG) is a common procedure in children. The outcomes of PEG could be affected by the associated disease. We aimed to evaluate the outcomes and safety of PEG tube placement in a tertiary care center with special attention to patients with cardiac disease, ventriculoperitoneal (VP) shunt, or peritoneal dialysis (PD) catheter. Methods: This retrospective study included 113 pediatric patients who had PEG tube insertion from 2011 to 2021. Eighteen patients (15.93%) had cardiac disease, five patients (4.42%) had PD catheters, and three patients (2.65%) had VP shunt. Results: The median age was 3 years (interquartile range: 1–6), and females represented 55% of our patients. The weight ranged from 2.57 to 60 kg, and the most common indication for insertion was neurological disease (n = 56; 49.56%). The median operative time was 30 (20–45) minutes. Pneumonia and vomiting were the most frequent complications (n = 20, 17.7%). Thirty‐day mortality occurred in four patients (3.54%) and 1‐year mortality in 10 patients (8.85%). Nine patients (7.96%) required fundoplication, and four patients (3.53%) had tube removal and reinsertion. There was no association between weight and postoperative complications (odds ratio: 0.97; P =.48). There were no differences in postoperative complications among patients with cardiac diseases, PD catheters, and VP shunts. No complications were reported in patients with VP shunt. One patient with cardiac disease and one patient with PD catheter required fundoplication. Removal and reinsertion were needed in one patient with a PD catheter. Conclusion: PEG is feasible in low‐weight infants with a low complication rate. The complication rate is low in patients with VP shunt, PD catheter, and cardiac patients. [ABSTRACT FROM AUTHOR]
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- 2022
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18. Outcomes of Percutaneous Peritoneal Dialysis Catheters Insertion by Interventional Radiologists: A Single-Institution Experience.
- Author
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Alhussaini, Khadijah, Abulqasim, Shaima, Al-Sharydah, Abdulaziz Mohammad, Elhassan, Elwaleed, and Arabi, Mohammad
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PERITONEAL dialysis ,INTERVENTIONAL radiology ,CATHETER ablation ,IMAGE-guided radiation therapy ,PERITONITIS - Abstract
Objectives This article evaluates the short- and long-term outcomes of percutaneous peritoneal dialysis (PD) catheters inserted by interventional radiology service and analyzes the factors that affect the sustainability of patent and functional PD catheters. Materials and Methods Retrospective single-institution study between April 2015 and February 2021. A total of 131 patients (75 males) were enrolled with mean age of 50 ± 19.6 years with an average body mass index (BMI) of 28 ± 7 kg/m
2 . Technical and clinical success were evaluated. Catheter-related complications were classified into mechanical and nonmechanical categories, including infectious complications. Indications for removal were analyzed. Results Technical and clinical success were 100%. The average dwelling time for the entire cohort was 497.5 ± 462.3 days. Forty-six patients (35%) were on PD at the last follow-up with an average dwelling time of 492 days. PD-related complications were reported in 79/131 (60.3%) patients, including peritonitis (40.46%; 53/131), followed by malposition/migration (12.21%; 16/131), tunnel/exit site infection (10.69%; 14/131), and dysfunction (12.21%; 16/131). The incidence of peritonitis within 30 days postinsertion was 9.43% (5/53). The average interval between insertion and migration was 100.5 ± 144.8 days (95% confidence interval, 6.9–14.4). There was a trend for a higher rate of malposition/migration in patients with higher BMI (p = 0.0561). Causes for PD catheters removal were: (1) infection-related (24.4%; 32/131), (2) renal transplant recipients (16%; 21/131), (3) mechanical complications (13.7%; 18/131), and (4) patient's preference (7.6%; 10/131). Conclusion Percutaneous PD catheter placement by interventional radiologists provides acceptable long-term outcomes and complication rates that meet the recommended standards. [ABSTRACT FROM AUTHOR]- Published
- 2022
- Full Text
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19. Catheter Access Management for Acute Peritoneal Dialysis
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Mohamed Amine Rahil and Achour Bouzgueg
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peritoneal dialysis catheter ,central venous access ,pediatric population ,peritoneal dialysis ,Diseases of the genitourinary system. Urology ,RC870-923 - Abstract
Insertion of a peritoneal dialysis (PD) catheter is frequently done by interventional nephrologists, but these procedures are typically only performed for adults. Almost all invasive procedures in children are performed by pediatric surgeons. If a pediatric surgeon is unavailable, the initiation of PD in acute situations may be delayed, thus increasing the risk of complications and chronic kidney disease. For these patients, the main obstacle to initiating renal replacement therapy is access, even when involving central vein catheter (CVC) or peritoneal access. Here we report the case of a 10-kg baby affected by hemolytic and uremic syndrome diarrhea in whom all of the procedures to manage the complications of acute kidney injury (PD catheter insertion, PD catheter revision, CVC placement, and CVC revision) were undertaken by interventional nephrologists. This experience allowed us to rapidly treat the acute kidney injury, recover normal kidney function thereby avoiding chronic complications, and allowing us to discharge the baby from the intensive care unit.
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- 2020
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20. Case Report: Synchronous Removal and Implantation of Peritoneal Dialysis Catheter Using Bilateral Transversus Abdominis Plane Block
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Ante Jakšić, Božidar Vujičić, Diana Deša, Antun Gršković, Ivan Vukelić, Josip Španjol, Sanjin Rački, and Dean Markić
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case-reports ,end-stage renal disease ,peritoneal dialysis catheter ,regional anesthesia ,transversus abdominis plane (TAP) block ,Medicine (General) ,R5-920 - Abstract
BackgroundPeritoneal dialysis (PD) surgery include PD catheter insertion and removal. Both procedures require the use of anesthesia. The end-stage renal disease (ESRD) patients usually have severe comorbidities. The general anesthesia, because of its negative systemic effect, should be omitted in this vulnerable group of the patients. Transversus abdominis plane (TAP) block as a newer method of regional anesthesia is a technique without systemic effect and recently started to be used in ESRD patients for PD catheter placement and/or removal. Here we report a patient in whom we for the first time simultaneously removed and implanted a PD catheter by using a bilateral transversus abdominis plane block.Case PresentationThe patient was an 80-year-old man who was admitted for removal of malfunctioned PD catheter. Since the patient opted for staying on PD simultaneous implantation of catheter was planned. Because of his age and significant comorbidities, general anesthesia was avoided and bilateral TAP block become our option. In the same anesthesia, using bilateral TAP block, the old PD catheter was removed and a new one was implanted. Until now the patient is on regular PD without any complications.ConclusionThe TAP block could be used as a primary anesthetic technique in ESRD patients for PD surgery even for synchronous removal and implantation of PD catheter.
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- 2022
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21. Intraperitoneal rupture of a Tenckhoff catheter.
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Guimarães MG, Ribeiro I, Rescala J, Menezes T, Peixoto M, Silva I, Lemos MR, Brito J, Passos LC, and Tapioca F
- Abstract
Competing Interests: Declaration of conflicting interestsThe authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
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- 2024
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22. Patient Selection and Planning for Image-Guided Peritoneal Dialysis Catheter Placement.
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Crabtree, John H. and Hathaway, Peter B.
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PREOPERATIVE care , *ULTRASONIC imaging , *PATIENT selection , *PERITONEAL dialysis , *INTERVENTIONAL radiology , *ANTICOAGULANTS , *SURGICAL site , *CATHETERIZATION , *COMPUTED tomography , *HEMORRHAGE - Abstract
Image-guided percutaneous peritoneal dialysis (PD) catheter insertion has become increasingly relied upon to provide urgent access for late presenting kidney failure patients, to overcome surgical backlogs and limited operating room access, to avoid general anesthesia in high-risk patients, and, by itself, as an alternative approach to surgical PD access. Advanced planning for the procedure is essential to assure the best possible outcome. Appropriate selection of patients for percutaneous PD catheter placement, choosing the most suitable catheter type, determining insertion and exit site locations, and final patient preparations facilitate the performance of the procedure, minimizes the risk of complications, and improves the likelihood of providing a successful long-term peritoneal access. [ABSTRACT FROM AUTHOR]
- Published
- 2022
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23. Complications of Percutaneous Peritoneal Dialysis Catheter.
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Oza-Gajera, Bharvi P., Abdel-Aal, Ahmed K., and Almehmi, Ammar
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THERAPEUTICS , *PERITONEAL dialysis , *RENAL replacement therapy , *MEDICAL protocols , *CATHETERIZATION complications , *ADVERSE health care events , *CATHETERIZATION , *CATHETERS - Abstract
A functional peritoneal dialysis (PD) catheter is the cornerstone for the success of renal replacement therapy. This success is largely dependent on adhering to best practices during catheter insertion, which starts with a comprehensive preoperative evaluation that helps in determining the catheter configuration type and both entry and exit sites. Additionally, following the best practice guidelines during PD catheter insertion minimizes undesirable complications and provides a durable functional access for dialysis. However, adverse complications are still encountered despite abiding with these clinical guidelines. These complications are categorized into mechanical and infectious groups. The description and management of these adverse events are discussed in detail in this article with particular attention to the technical pitfalls that can occur during catheter insertion. Avoiding these pitfalls can minimize PD catheter complications and potentially improve clinical outcomes. [ABSTRACT FROM AUTHOR]
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- 2022
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24. The Role of SPECT/CT in Peritoneal Scintigraphy in the Era of Low-Dose Imaging: A Case Report.
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Newallo, Domnique S., Chataigne, Michara, and Muzahir, Saima
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SINGLE-photon emission computed tomography , *RADIONUCLIDE imaging , *DELAYED diagnosis , *DRUG instillation , *DIALYSIS catheters - Abstract
Peritoneal scintigraphy, although rarely used, plays a vital role in the diagnosis of peritoneal dialysis catheter complications. Reported complications include spontaneous hydrothorax secondary to a pleuroperitoneal fistula, which requires the abandonment of peritoneal dialysis, given that a delay in diagnosis can lead to worsening clinical status. Previously reported peritoneal scintigraphy protocols recommended intraperitoneal instillation of radiotracer and moderate-to-large volumes of dialysate or sterile saline ranging from 350 to 2,000 mL. However, smaller volumes, in conjunction with the use of single-photon emission computed tomography/computed tomography, are not verified in patients receiving peritoneal scintigraphy imaging. [ABSTRACT FROM AUTHOR]
- Published
- 2022
- Full Text
- View/download PDF
25. Percutaneous insertion of peritoneal dialysis catheters by the nephrologist (modified Seldinger technique)
- Author
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Karlien Francois, Dieter De Clerck, Tom Robberechts, Freya Van Hulle, Stefan Van Cauwelaert, Ine Luyten, and Daniel Jacobs-Tulleneers-Thevissen
- Subjects
kidney failure ,peritoneal dialysis ,peritoneal dialysis catheter ,dialysis ,Seldinger ,Internal medicine ,RC31-1245 - Abstract
A proper functioning access to the peritoneal cavity is the first and foremost requirement to start peritoneal dialysis. Most commonly, peritoneal dialysis catheters are inserted using a surgical approach. Laparoscopic peritoneal dialysis catheter insertion is the recommended surgical technique because it offers to employ advanced adjunctive procedures that minimize the risk of mechanical complications. In patients with low risk of mechanical catheter complications, such as patients without prior history of abdominal surgery or peritonitis, and in patients ineligible for general anesthesia, the percutaneous approach of peritoneal dialysis catheter insertion is an alternative to surgical catheter insertion. Percutaneous insertion of peritoneal dialysis catheters can be performed by a dedicated nephrologist, interventional radiologist, surgeon or nurse practitioner under local anesthesia, either with or without image guidance using ultrasound or fluoroscopy. Several reports show similar catheter function rates, mechanical and infectious complications and catheter survival for percutaneously inserted peritoneal dialysis catheters compared to surgically inserted peritoneal dialysis catheters. This article describes the percutaneous insertion of peritoneal dialysis catheters technique adopted at Universitair Ziekenhuis Brussel since 2015. Our technique is a simple low-tech modified Seldinger procedure performed by the nephrologist and not using fluoroscopy guidance. We describe the excellent outcomes of our percutaneously inserted peritoneal dialysis catheters and offer a practical guide to set up your own percutaneous catheter insertion program.
- Published
- 2021
- Full Text
- View/download PDF
26. 不同腹膜透析置管相关技术对患者预后影响的 Meta 分析.
- Author
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杜 渊, 蒋宏伟, 李春庆, and 谢 燕
- Subjects
- *
PERITONEAL dialysis , *SURGICAL site , *DATABASE searching , *DIALYSIS catheters , *HEMODIALYSIS patients , *ODDS ratio - Abstract
OBJECTIVE: For peritoneal dialysis patients, the more therapeutic way of insertion catheterization techniques is controversial. There is no evidence of highgrade evidence-based medicine. This study systemically assessed influence of different insertion catheterization techniques on the prognosis of peritoneal dialysis patients, and reviewed the clinical value of percutaneous insertion catheterization in peritoneal dialysis. METHODS: The PubMed, EMbase, the Cochrane Library, CNKI, VIP, and Wanfang databases of cohort study literature on the comparison of percutaneous technique and surgical incision technique for peritoneal dialysis catheterization published from inception to October 30, 2019 were searched by computer. The effective data were selected and the Newcastle-Ottawa Scale was used to evaluate the quality. Primary outcomes were infection complications, mechanical complications, 1-year peritoneal dialysis tube survival rate, and extubation rate caused by complications. The odds ratio (OR) was the effect indicator. Metaanalysis was performed using RevMan 5.3 software. RESULTS: (1) A total of 12 studies were included, including 2 prospective cohort studies and 10 retrospective cohort studies. A total of 2 203 patients were enrolled, including 1 164 patients in the percutaneous puncture group and 1 039 patients in the peritoneal incision group. (2) The incidence of infection complications, the incidence of mechanical complications, and the 1-year catheter survival rate were not statistically significant between the percutaneous puncture group and the peritoneal incision group (OR=0.57, 95%CI:0.31-1.04, P=0.07: OR=0.88, 95%CI:0.77-1.09, P=0.25; OR=1.05, 95%CI:0.68-1.64, P=0.81). (3) The extubation rate caused by complications in the percutaneous puncture group was lower than in the peritoneal incision group (OR=0.59, 95%CI:0.47- 0.74, P < 0.000 1). (4) Subgroup analysis results of cases of infection complications group and 1-year catheter survival rate group according to the type of study suggested that heterogeneity mainly came from retrospective study subgroups, and the meta-analysis results in each subgroup showed there was no significant difference between the two groups. (5) Funnel diagram analysis results showed mild publication bias in dialysis tube infection complications and 1-year survival rate of the included articles. CONCLUSION: It is safe and effective to apply the peritoneal dialysis catheterization with a percutaneous insertion technique, and its clinical effects and prognosis are similar with the traditional open surgical technique. The percutaneous insertion technique could be an ideal alternative to the traditional one. [ABSTRACT FROM AUTHOR]
- Published
- 2021
27. Unusual communication of an embedded peritoneal dialysis catheter with the colon before use: a case report with literature review
- Author
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Takaya Handa, Hiroyuki Suzuki, Hiroyuki Matsubara, Hiroaki Terajima, and Tatsuo Tsukamoto
- Subjects
Peritoneal dialysis ,Bowel perforation ,Computed tomography peritoneography ,Peritoneal dialysis catheter ,Diseases of the genitourinary system. Urology ,RC870-923 - Abstract
Abstract Background Bowel perforation in peritoneal dialysis (PD) is mainly caused during the perioperative period. Delayed bowel perforation is difficult to diagnose because of its heterogenous clinical signs and rarity. Previously, the methods to diagnose delayed bowel perforation were invasive, but computed tomography (CT) peritoneography is now employed as a less invasive method. There have been no literature reviews on delayed bowel perforation, including recent cases using CT peritoneography. Delayed bowel perforation before PD initiation has rarely been reported and was mostly after PD initiation. Here, we present a case and literature review of delayed bowel perforation before PD initiation possibly caused by mechanical compression of the PD catheter implanted by the Moncrief–Popovich technique. Case presentation A PD catheter was embedded in a 57-year-old woman with autosomal-dominant polycystic kidney disease, with the distal end of the PD catheter buried under the skin. She had no gastrointestinal symptoms, except renal failure progression, during conservative therapy. Nine months later, she was admitted to our hospital to exteriorize the distal end of the PD catheter. Immediately after the first PD solution was infused into her abdomen, she complained of watery diarrhea. CT peritoneography revealed an outflow of contrast media through the PD catheter into the luminal side of the sigmoid colon, suggesting an interaction between the PD catheter and the colon. Laparoscopic examination revealed that the lateral side of the PD catheter (5 cm from the catheter tip) had adhered to the sigmoid colon and that a small orifice had formed where the side hole of the catheter was attached to the colon. The lesion was entirely surrounded by fibrous tissue that prevented leakage of the intraluminal contents. After restoring the colon with a colostomy, the patient was treated with hemodialysis. Seven months later, she underwent closure of the colostomy. Conclusions Although perforation of the colon by a PD catheter through the side hole is very rare, it is important to consider the interaction of dialysis fluid with the gut if diarrhea or abdominal pain occurs after PD initiation. CT peritoneography may be helpful in identifying the bowel perforation site with minimal invasiveness.
- Published
- 2019
- Full Text
- View/download PDF
28. Effects of prophylactic antibiotics before peritoneal dialysis catheter implantation on the clinical outcomes of peritoneal dialysis patients
- Author
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Xihui Liu, Xiaoyan Zuo, Xia Sun, and Zhao Hu
- Subjects
peritoneal dialysis ,peritoneal dialysis catheter ,prophylaxis ,antibiotics ,peritonitis ,Diseases of the genitourinary system. Urology ,RC870-923 - Abstract
Background: Peritoneal dialysis (PD) related infections, such as peritonitis, are still the main obstacle for the development of PD. Prophylactic antibiotic as one of the interventions to prevent early peritonitis was recommended to use before PD catheter insertion by International Society for Peritoneal Dialysis (ISPD) guidelines, In our hospital, however, since 2012, the prophylactic antibiotics for insertion of PD catheters were not allowed to use because of our hospital’s regulation. In order to analyze the outcomes of PD patients without using prophylactic antibiotics before the PD catheter insertion, we compared the PD patients with or without prophylactic antibiotics before PD catheter insertion. Methods: This retrospective study included 247 patients undergoing permanent PD catheter placement with conventional open surgical method consecutively between February 2008 and June 2013. Of these, 154 patients were given intravenous cefazolin, 1.0 g, 0.5–2 h before the procedure (antibiotic group) and 93 patients were not given prophylactic antibiotics (nonantibiotic group). All the patients were administered intermittent PD within 24 h after PD catheter insertion. The early complications and long-term outcomes were recorded respectively. Results: There was no significant difference in the incidence of peritonitis and exit-site/tunnel infection and mechanical complications between the two groups in the first 30 days after the PD catheter implantation. In addition, after 6 years of follow-up, no difference was seen between the two groups in patient survival, technique survival, and peritonitis-free survival. Conclusions: Our study does not show any beneficial effect of antibiotic prophylaxis in reducing the postoperative peritonitis.
- Published
- 2019
- Full Text
- View/download PDF
29. Pre-sternal and Extended Catheters
- Author
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Aziz, Fahad, Kirt Nichols, W., and Haggerty, Stephen, editor
- Published
- 2017
- Full Text
- View/download PDF
30. Overview of Catheter Choices and Implantation Techniques
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Di Cocco, Pierpaolo, Brown, Edwina A., Papalois, Vassilios E., Dor, Frank J. M. F., and Haggerty, Stephen, editor
- Published
- 2017
- Full Text
- View/download PDF
31. Surgical Considerations for Open Placement of Peritoneal Dialysis Catheters
- Author
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Krezalek, Monika A. and Haggerty, Stephen, editor
- Published
- 2017
- Full Text
- View/download PDF
32. Diagnosis and Management of Catheter Dysfunction
- Author
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Ogunc, Guner and Haggerty, Stephen, editor
- Published
- 2017
- Full Text
- View/download PDF
33. Buried Catheters: How and Why?
- Author
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Furgeson, Seth B., Teitelbaum, Isaac, and Haggerty, Stephen, editor
- Published
- 2017
- Full Text
- View/download PDF
34. Post-operative Protocol and Maintenance of Function
- Author
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McCormick, Brendan and Haggerty, Stephen, editor
- Published
- 2017
- Full Text
- View/download PDF
35. Hemodialysis Access in North America
- Author
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Arya, Shipra, Dalal, Sidd, Brewster, Luke P., and Dardik, Alan, editor
- Published
- 2017
- Full Text
- View/download PDF
36. Nonsurgical and Minimally Invasive Correction of Peritoneal Dialysis Catheter Complications.
- Author
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Lew, Susie Q.
- Subjects
- *
MEDICAL equipment reliability , *FOREIGN body migration , *DIALYSIS catheters , *PERITONEAL dialysis , *CONTINUING education units - Abstract
Peritoneal dialysis catheter complications that require nonsurgical or noninvasive correction by peritoneal dialysis (PD) nurses or practitioner are reviewed. Topics reviewed include compromised PD fluid flow, pericatheter fluid leakage, mechanical integrity disruption, catheter extrusion, and exit site/tunnel complications. [ABSTRACT FROM AUTHOR]
- Published
- 2021
- Full Text
- View/download PDF
37. Comparison of peritoneal dialysis catheter insertion techniques by nephrologists: Surgical vs blind methods.
- Author
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Kang, Seok Hui, Park, Jong Won, Cho, Kyu Hyang, and Do, Jun Young
- Subjects
- *
PERITONEAL dialysis , *OPERATIVE surgery , *ABDOMINAL surgery , *DIALYSIS catheters , *HEMODIALYSIS patients - Abstract
Background: The aim of the present study was to perform a comparative analysis of peritoneal dialysis catheter (PDC) insertion between blind and surgical methods by nephrologists. Patients and Methods: The present study enrolled 249 peritoneal dialysis patients who received first‐time PDC insertion. All PDC insertions were performed using either the blind or surgical method. In our hospital during the study period, two of three nephrologists performed the blind method routinely in all eligible patients (blind group), and one of three nephrologists performed the surgical method in all eligible patients (surgical group). Catheter outcomes, including infectious or mechanical complications, functional parameters, and catheter survival, were evaluated. Results: The numbers of patients underwent surgical or blind methods were 105 and 144, respectively. The use of systemic analgesics in the surgical group was higher than that in the blind group. The operation time was longer in the blind group than in the surgical group. The D0 level and peritoneal Kt/V were similar between the two groups. There was no significant difference in infectious and mechanical complications between the two groups. The catheter survival and intervention‐free survival were similar between the two groups (P =.995 for catheter survival and P =.723 for intervention‐free survival). Conclusion: Our study shows that catheter outcomes are similar between blind and surgical insertion techniques performed by nephrologists. These findings reveal that patients without previous major abdominal surgery would be suitable to receive any one of the two methods according to the operator‐friendly technique. [ABSTRACT FROM AUTHOR]
- Published
- 2021
- Full Text
- View/download PDF
38. A standardized technique of laparoscopic placement of peritoneal dialysis catheter with omentectomy and closure of patent processus vaginalis: A 3-in-1 minimally invasive surgical approach in children.
- Author
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Wong, Yuenshan Sammi, Pang, Kristine Kit Yi, Ma, Alison Lap Tak, Tong, Pak Chiu, and Tam, Yuk Him
- Abstract
Omental wrapping is a common cause for catheter failure in children on peritoneal dialysis (PD). Previous studies are conflicting in the benefits of omentectomy. We conducted a retrospective study comparing children who underwent PD catheter placement by a standardized laparoscopic three-in-one technique (lap3-in-1) from 2013 to 2018 versus a historical control cohort by open surgery without omentectomy. Lap3-in-1technique combined catheter placement with well-defined indication and extent of omentectomy, and closure of any patent processus vaginalis (PPV). There were 33 and 32 children in the lap3-in-1 and control cohorts respectively. 4/33(12.1%) in lap3-in-1 had reoperations for catheter failures which equated 1 reoperation per 144 catheter months. No reoperations were performed in lap3-in-1 cohort for omental wrapping or inguinal hernia, compared with 13/32 (41%; p < 0.001) and 5/32 (16%; p = 0.02) in the control cohort. Kaplan Meier survival curves showed significantly longer catheter life in the lap3-in-1 cohort (p < 0.001). In multivariate analysis by the COX proportional hazards model, the lap3-in-1 approach had significantly reduced risk of reoperation for catheter failure (HR 0.11; 95% CI: 0.04–0.31; p < 0.001). The lap3-in-1 technique is effective in selecting those children who would benefit from omentectomy, and avoiding a second operation for inguinal hernia which develops after PD. Treatment study, level III [ABSTRACT FROM AUTHOR]
- Published
- 2020
- Full Text
- View/download PDF
39. When end-stage kidney disease complicates abdominal surgery.
- Author
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Lew, Susie Q. and Collins, Ashté
- Subjects
- *
CHRONIC kidney failure , *ABDOMINAL surgery , *ABDOMINAL diseases , *PERITONEAL dialysis , *GYNECOLOGIC surgery - Abstract
Patients receiving peritoneal dialysis (PD) encounter an increased risk for infection, bleeding, and PD fluid leakage after abdominal surgery. These complications may affect the future use of PD. Appropriate patient preparation may mitigate complications. Certain complications or procedures allow patients to remain on PD while others require transition to hemodialysis. We review the etiology and management of infection, bleeding, and PD fluid leakage associated with abdominal surgery as well as the relationship of specific abdominal procedures to continuing PD. [ABSTRACT FROM AUTHOR]
- Published
- 2020
- Full Text
- View/download PDF
40. Peritoneal Dialysis Access
- Author
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Warady, Bradley A., Andrews, Walter S., Geary, Denis F., editor, and Schaefer, Franz, editor
- Published
- 2016
- Full Text
- View/download PDF
41. Peritoneal catheter infections : data from the French language peritoneal dialysis registry (RDPLF), risk factors
- Author
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Isabelle Vernier, Emmanuel Fabre, Max Dratwa, and Christian Verger
- Subjects
peritoneal dialysis ,peritoneal dialysis catheter ,catheter infection ,dialyse péritonéale ,cathéter dialyse péritonéale ,Internal medicine ,RC31-1245 - Abstract
Peritoneal catheter infections : data from the French language peritoneal dialysis registry (RDPLF), risk factors The French Language Peritoneal Dialysis Registry (RDPLF) record since 1997 all data dealing with peritoneal catheter insertion and follow up. The aim of this study is to analyze catheter infections on 10801 catheters in 144 centres from January 1, 1997 and December 31, 2018. Infections are more common in the first month and 50% occur before the tenth month. The risk of infection increases in case of wall hematoma, initial fluid leakage, and obesity. It decreases with the use of prophylactic antibiotics at the time of catheter insertion, with experienced operator, if the first dressing is delayed for 7 days, and with mupirocin as exit-site prophylaxis. During last two decades the percentage of Staphylococcus aureus infections has decreased, whereas the proportion of Pseudomonas, Corynebacterium and other Gram + cocci increased. The incidence of catheter infections is low compared to literature data: it decreased to 0.16 episodes per year for the 2013-2017 period. Adherence to ISPD guidelines: preoperative antibioprophylaxis is the most followed guideline (70.7% of catheter implantations in 2018). Local antibioprophylaxis concerns only 15.6% of catheters, and remains concentrated in a few centres ; mupirocin is the most frequently used agent. Screening for nasal carriage of S. aureus is performed in only 42% of cases. The catheter section of the RDPLF has allowed the follow-up of clinical practices incidence of infections and ecology for 21 years, both at the national and center level Our study confirms a wide variability in clinical practices, compared to ISPD guidelines.
- Published
- 2019
- Full Text
- View/download PDF
42. Comparison of different peritoneal dialysis catheters on complication and catheter survival: A network meta-analysis of randomised controlled trials.
- Author
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Zhao L, Yu Z, Li X, Zhao J, Qin Y, Zhou M, Bai M, Xu G, and Sun S
- Abstract
Background: This network meta-analysis (NMA) aimed to compare the clinical advantage of four commonly used peritoneal dialysis catheters (PDCs) including the Swan neck segment with straight tip (Swan neck + S), Tenckhoff segment with straight tip (Tenckhoff + S), Swan neck segment with coiled tip (Swan neck + C) and Tenckhoff segment with coiled tip (Tenckhoff + C)., Methods: Randomised clinical trials were searched from PubMed, Embase, the Cochrane Register of clinical trials, China National Knowledge Infrastructure (CNKI) and ChinaInfo from their inception until July 31, 2022. Meta-analysis was performed using Stata 14.0 and RevMan 5.3.5 software to evaluate the four commonly used PDCs., Results: Seventeen studies involved 1578 participants were included. NMA showed that compared with Swan neck + C, Swan neck + S significantly reduced catheter tip migration (OR 0.47 95% CI 0.22-0.99). Tenckhoff + S was more effective in reducing catheter dysfunction (OR 0.42, 95% CI 0.23-0.79), catheter tip migration with dysfunction (OR 0.19, 95% CI 0.05-0.78) and catheter removal (OR 0.56, 95% CI 0.34-0.93) which were consistent with the pairwise meta-analysis. According to the surface under the cumulative ranking curve, Swan neck + S emerged as the best PDC in the reduction of catheter tip migration (83.3%), followed by Tenckhoff + S (79.4%). Moreover, Tenckhoff + S (86.5%, 76.3%) and Swan neck + S (72.3, 86.9%) ranked as the first and second PDC for 1 and 2-year technique survival which was significantly higher than those of the other two PDCs., Conclusion: Our NMA showed Swan neck + S and Tenckhoff + S tended to be more efficacious than Swan neck + C and Tenckhoff + C in lowering the mechanical dysfunction and prolonging the technique survival, which may contribute to better clinical decisions. More randomised controlled trials with larger scales and higher quality are needed in order to obtain more credible evidence., Competing Interests: Declaration of conflicting interestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
- Published
- 2024
- Full Text
- View/download PDF
43. Intraperitoneal extension of the peritoneal dialysis catheter—a new technique for catheter implantation in patients with obesity
- Author
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Sayer, Michael, Thiel, Christian, Schenk, Martin, Königsrainer, Alfred, Heyne, Nils, Birkenfeld, Andreas L., Artunc, Ferruh, and Thiel, Karolin
- Published
- 2022
- Full Text
- View/download PDF
44. Dialysis Access
- Author
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Olaitan, Oyedolamu K., Hollinger, Edward F., Saclarides, Theodore J., editor, Myers, Jonathan A., editor, and Millikan, Keith W., editor
- Published
- 2015
- Full Text
- View/download PDF
45. Catheter Access Management for Acute Peritoneal Dialysis.
- Author
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Rahil, Mohamed Amine and Bouzgueg, Achour
- Subjects
PERITONEAL dialysis ,DIALYSIS catheters ,HEMOLYTIC-uremic syndrome ,CATHETERS ,PEDIATRIC surgeons ,CHRONIC kidney failure ,THROMBOTIC thrombocytopenic purpura - Abstract
Insertion of a peritoneal dialysis (PD) catheter is frequently done by interventional nephrologists, but these procedures are typically only performed for adults. Almost all invasive procedures in children are performed by pediatric surgeons. If a pediatric surgeon is unavailable, the initiation of PD in acute situations may be delayed, thus increasing the risk of complications and chronic kidney disease. For these patients, the main obstacle to initiating renal replacement therapy is access, even when involving central vein catheter (CVC) or peritoneal access. Here we report the case of a 10-kg baby affected by hemolytic and uremic syndrome diarrhea in whom all of the procedures to manage the complications of acute kidney injury (PD catheter insertion, PD catheter revision, CVC placement, and CVC revision) were undertaken by interventional nephrologists. This experience allowed us to rapidly treat the acute kidney injury, recover normal kidney function thereby avoiding chronic complications, and allowing us to discharge the baby from the intensive care unit. [ABSTRACT FROM AUTHOR]
- Published
- 2020
- Full Text
- View/download PDF
46. Effects of prophylactic antibiotics before peritoneal dialysis catheter implantation on the clinical outcomes of peritoneal dialysis patients.
- Author
-
Liu, Xihui, Zuo, Xiaoyan, Sun, Xia, and Hu, Zhao
- Subjects
PERITONEAL dialysis ,DIALYSIS catheters ,HEMODIALYSIS patients ,ANTIBIOTICS ,CATHETERIZATION ,CEFAZOLIN ,HOSPITAL laws - Abstract
Background: Peritoneal dialysis (PD) related infections, such as peritonitis, are still the main obstacle for the development of PD. Prophylactic antibiotic as one of the interventions to prevent early peritonitis was recommended to use before PD catheter insertion by International Society for Peritoneal Dialysis (ISPD) guidelines, In our hospital, however, since 2012, the prophylactic antibiotics for insertion of PD catheters were not allowed to use because of our hospital's regulation. In order to analyze the outcomes of PD patients without using prophylactic antibiotics before the PD catheter insertion, we compared the PD patients with or without prophylactic antibiotics before PD catheter insertion. Methods: This retrospective study included 247 patients undergoing permanent PD catheter placement with conventional open surgical method consecutively between February 2008 and June 2013. Of these, 154 patients were given intravenous cefazolin, 1.0 g, 0.5–2 h before the procedure (antibiotic group) and 93 patients were not given prophylactic antibiotics (nonantibiotic group). All the patients were administered intermittent PD within 24 h after PD catheter insertion. The early complications and long-term outcomes were recorded respectively. Results: There was no significant difference in the incidence of peritonitis and exit-site/tunnel infection and mechanical complications between the two groups in the first 30 days after the PD catheter implantation. In addition, after 6 years of follow-up, no difference was seen between the two groups in patient survival, technique survival, and peritonitis-free survival. Conclusions: Our study does not show any beneficial effect of antibiotic prophylaxis in reducing the postoperative peritonitis. [ABSTRACT FROM AUTHOR]
- Published
- 2019
- Full Text
- View/download PDF
47. Peritoneal dialysis catheter insertion using a very-low-site approach: a 5-year experience.
- Author
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Gong, Li-Feng, Lu, Jing-Kui, Tang, Wei-Gang, Xu, Wei, Xu, Ming, and Ma, Gui-Xiang
- Abstract
Purpose: Peritoneal dialysis (PD) catheter tip migration accounts for the majority of cases of PD catheter malfunction. In this case series, we described our experiences of using a modified PD catheter implantation approach through a site that is lower than the site that is conventionally used, to reduce catheter malfunction. Methods: We retrospectively identified 76 patients who received PD catheter implantation at the Affiliated Wujin Hospital of Jiangsu University, among whom 39 received the traditional approach of low-site insertion and 37 received a modified approach of very-low-site insertion. All participants were followed up for at least 2 years after PD catheter implantation, and the development of catheter dysfunction or death during this period was monitored. Results: We found that the survival rate of the initially inserted catheter was 75.68% among the very-low-site group. This survival rate was significantly better than that observed among the low-site group (48.72%; p = 0.029). Kaplan–Meier curves of the initial catheter survival also showed that the catheter survival was significantly higher in the patients in the very-low-site group than those in the low-site group (log rank p = 0.012). Complications, such as catheter tip migration, were not observed in the very-low-site group, while tip migration occurred in 15.38% of the patients in the low-site group (very-low-site group vs low-site group: p = 0.039). Conclusions: A safe and simple PD catheter implantation can be performed either through the low-site approach or the very-low-site approach. [ABSTRACT FROM AUTHOR]
- Published
- 2019
- Full Text
- View/download PDF
48. Surgical versus percutaneous catheter placement for peritoneal dialysis: an updated systematic review and meta-analysis
- Author
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Esagian, Stepan M., Sideris, Georgios A., Bishawi, Muath, Ziogas, Ioannis A., Lehrich, Ruediger W., Middleton, John P., Suhocki, Paul V., Pappas, Theodore N., and Economopoulos, Konstantinos P.
- Published
- 2021
- Full Text
- View/download PDF
49. Inferior epigastric artery injury after percutaneous imaging-guided peritoneal dialysis catheter placement
- Author
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Ammar Almehmi, Emily A Dryer, and Masa Abaza
- Subjects
medicine.medical_specialty ,Percutaneous ,business.industry ,Peritoneal dialysis catheter ,R895-920 ,Case Report ,Imaging Guidance ,Iatrogenic arterial injury ,Surgery ,Embolization ,Medical physics. Medical radiology. Nuclear medicine ,medicine.artery ,Hemoperitoneum ,medicine ,Radiology, Nuclear Medicine and imaging ,Inferior epigastric artery ,business - Abstract
Inferior epigastric artery (IEA) injury is a rare clinical entity that is usually associated with abdominal wall procedures and injuries though can also be spontaneous, particularly in individuals with coagulopathy. Of all described mechanisms of injury, percutaneous peritoneal dialysis (PD) catheter insertion is a rarely encountered, particularly in instances where insertion is performed under imaging guidance. While this injury is self-limited, it can be associated with hemodynamic instability and acute blood loss anemia, which can be fatal if left untreated. Computed tomographic (CT) angiography is the diagnostic method of choice. Transcatheter arterial embolization is an effective treatment modality with a high success rate. Here, we describe a 41-year-old female who underwent percutaneous PD catheter insertion that, despite intraprocedural imaging guidance, was complicated by large hemoperitoneum and clinical instability. Prompt identification of IEA injury followed by immediate intervention with coil embolization led to a successful outcome for this patient in the setting of a life-threatening uncommon complication of such procedure. The details of the diagnostic evaluation and management are outlined.
- Published
- 2022
50. An unusual case of peritoneal dialysis-associated bacterial peritonitis caused by Weeksella virosa.
- Author
-
Unalan, Tugce, Karagoz, Alper, Bayhan, Cihangul, Ozsurekci, Yasemin, and Hazirolan, Gulsen
- Subjects
CEFEPIME ,DIALYSIS catheters ,MICROBIAL sensitivity tests ,BETA lactamases ,PERITONEAL dialysis ,ADDISON'S disease ,PERITONITIS - Abstract
Weeksella virosa is an atypical Gram-negative bacterium that does not grow on MacConkey agar. In this report, we present a 4-year-old female patient with Addison's disease and end-stage renal failure secondary to focal sclerosing glomerulosclerosis. Continuous ambulatory peritoneal dialysis had been performed, and 3 months later, the patient developed fever, diarrhea, and vomiting. Peritoneal fluid culture and dialysis fluid culture were positive for W. virosa. It was identified with Phoenix (BD, USA) and confirmed via 16S rRNA sequencing. It cannot be identified by Maldi Biotyper (Bruker). The isolate was found to be resistant to cephalosporins, ciprofloxacin, and amikacin by gradient test. Intraperitoneal cefepime was initiated but since antimicrobial susceptibility testing revealed cephalosporin resistance, therapy was changed to intraperitoneal meropenem. Following the removal of peritoneal dialysis catheter, fever, abdominal distention, and vomiting were resolved. Piperacillin, aztreonam, and carbapenems can be used for empirical therapy. Antimicrobial susceptibility testing should be performed to guide the choice of treatment. Removal of peritoneal dialysis catheter is an important step of management of this infection. To our knowledge, this is the first report of W. virosa in a pediatric patient and first report from Turkey. [ABSTRACT FROM AUTHOR]
- Published
- 2021
- Full Text
- View/download PDF
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