Kidney international reports · 2026
Randomized Clinical Trial on the Efficacy and Safety of Preoperative Enema in the Prevention of Peritoneal Dialysis Catheter Dysfunction.
СтатьяНазвание и аннотация: Перевод в очереди
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Zhao Lijuan, Zhao Jin, Xing Yan, Bai Ming, Xu Guoshuang, Li Xiayin, Zhou Meilan, Yu Yan, Yang Jun, Sun Shiren
Аннотация
INTRODUCTION: Current clinical practice guidelines do not universally recommend bowel preparation for peritoneal dialysis (PD) catheter insertion. This randomized controlled trial aimed to evaluate the efficacy and safety of preoperative enema in preventing PD catheter dysfunction.
METHODS: In this prospective, single-center trial, 136 patients undergoing PD catheterization were randomly assigned to receive either preoperative enema within 24 hours (enema group, n = 68) or no bowel preparation (control group, n = 68). The primary end point was the incidence of catheter dysfunction requiring intervention within 3 months postoperation. Secondary outcomes encompassed the incidence of catheter dysfunction requiring intervention in 6 months, catheter event free survival time, the incidence of PD-associated peritonitis, and other catheter-related complications.
RESULTS: One hundred thirty-four participants completed the 6-month follow-up after excluding 2 patients (1 with scrotal leakage and 1 with acute kidney injury). Baseline characteristics showed no significant intergroup differences. The enema group demonstrated significantly lower incidence of catheter dysfunction requiring intervention at 3 months (10/68 [14.7%], unadjusted risk ratio (RR): 0.297, [95% confidence interval (CI): 0.129-0.682], P = 0.004; adjusted RR 0.299 [95% CI: 0.121-0.737], P = 0.009). Kaplan-Meier analysis revealed longer catheter survival time in the enema group versus controls (log-rank P = 0.0015). Only 1 control patient (1.5%) required surgical revision. There was no statistically significant difference between the 2 groups in terms of other infection and noninfection complications.
CONCLUSION: Preoperative enema significantly reduces early PD catheter dysfunction risk without increasing complication rates. These findings support incorporating bowel preparation into standard preoperative protocols for PD catheter placement.
METHODS: In this prospective, single-center trial, 136 patients undergoing PD catheterization were randomly assigned to receive either preoperative enema within 24 hours (enema group, n = 68) or no bowel preparation (control group, n = 68). The primary end point was the incidence of catheter dysfunction requiring intervention within 3 months postoperation. Secondary outcomes encompassed the incidence of catheter dysfunction requiring intervention in 6 months, catheter event free survival time, the incidence of PD-associated peritonitis, and other catheter-related complications.
RESULTS: One hundred thirty-four participants completed the 6-month follow-up after excluding 2 patients (1 with scrotal leakage and 1 with acute kidney injury). Baseline characteristics showed no significant intergroup differences. The enema group demonstrated significantly lower incidence of catheter dysfunction requiring intervention at 3 months (10/68 [14.7%], unadjusted risk ratio (RR): 0.297, [95% confidence interval (CI): 0.129-0.682], P = 0.004; adjusted RR 0.299 [95% CI: 0.121-0.737], P = 0.009). Kaplan-Meier analysis revealed longer catheter survival time in the enema group versus controls (log-rank P = 0.0015). Only 1 control patient (1.5%) required surgical revision. There was no statistically significant difference between the 2 groups in terms of other infection and noninfection complications.
CONCLUSION: Preoperative enema significantly reduces early PD catheter dysfunction risk without increasing complication rates. These findings support incorporating bowel preparation into standard preoperative protocols for PD catheter placement.