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Percutaneous peritoneal dialysis catheter implantation with no break-in period: A viable option for patients requiring unplanned urgent-start peritoneal dialysis

Kidney Research and Clinical Practice 2020년 39권 3호 p.365 ~ 372
김주희, 김민정, Ye Byung-Min, 김준현, 김민정, 김서린, 김일영, 김효진, 한미연, 이하린, 송상헌, 성은영, 이수봉, 이동원,
소속 상세정보
김주희 ( Kim Joo-Hui ) - Pusan National University School of Medicine Department of Internal Medicine
김민정 ( Kim Min-Jeong ) - Gimhae Bokum Hospital Department of Internal Medicine
 ( Ye Byung-Min ) - Pusan National University School of Medicine Department of Internal Medicine
김준현 ( Kim June-Hyun ) - Pusan National University School of Medicine Department of Internal Medicine
김민정 ( Kim Min-Jeong ) - Pusan National University School of Medicine Department of Internal Medicine
김서린 ( Kim Seo-Rin ) - Pusan National University School of Medicine Department of Internal Medicine
김일영 ( Kim Il-Young ) - Pusan National University School of Medicine Department of Internal Medicine
김효진 ( Kim Hyo-Jin ) - Pusan National University School of Medicine Department of Internal Medicine
한미연 ( Han Mi-Yeun ) - Pusan National University School of Medicine Department of Internal Medicine
이하린 ( Rhee Ha-Rin ) - Pusan National University School of Medicine Department of Internal Medicine
송상헌 ( Song Sang-Heon ) - Pusan National University School of Medicine Department of Internal Medicine
성은영 ( Seong Eun-Young ) - Pusan National University School of Medicine Department of Internal Medicine
이수봉 ( Lee Soo-Bong ) - Pusan National University School of Medicine Department of Internal Medicine
이동원 ( Lee Dong-Won ) - Pusan National University School of Medicine Department of Internal Medicine

Abstract


Background: Urgent-start peritoneal dialysis (PD) is applied to patients who need PD within two weeks but are able to wait for more than 48 hours before starting PD. To evaluate the usefulness of percutaneous PD catheter insertion in urgent-start PD, we reviewed the clinical outcomes of percutaneous catheter insertion with immediate start PD and surgical insertion with longer break-in time in Pusan National University Hospital.

Methods: This study included 177 patients who underwent urgent-start PD. Based on the PD catheter insertion techniques, the patients with urgent-start PD were divided into percutaneous (n = 103) and surgical (n = 74) groups. For the percutaneous group, a modified Seldinger percutaneous catheter insertion with immediate initiation of continuous ambulatory PD was performed by nephrologists.

Results: The percutaneous group showed higher serum urea nitrogen, creatinine, and lower serum albumin compared with the surgical group (P < 0.05). Ninety-day infectious and mechanical complications showed no significant differences between the two groups. Ninety-day peritonitis in the percutaneous group was 9.7% compared to 5.4% in the surgical group (P = not significant [NS]). Major leakage was 3.9% in the percutaneous group compared to 1.4% in the surgical group (P = NS). Overall infectious and mechanical complication-free survival was not significantly different between the two groups. The percutaneous group and surgical group showed no statistical difference with respect to catheter survival over the entire observation period (P = NS).

Conclusion: This study suggests that urgent-start PD can be applied safely with percutaneous catheter insertion by nephrologists with no break-in period.

키워드

Catheters; Complications; Peritoneal dialysis; Urgent-start

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