The Effect of Obesity on Outcomes of Percutaneous Peritoneal Dialysis Catheter Insertion by Interventional Radiologists.

PURPOSE: To assess the feasibility and safety of percutaneous peritoneal dialysis (PD) catheter insertion in obese patients.

MATERIALS AND

METHODS

This single-center retrospective study included 125 consecutive patients who underwent PD catheter insertion by an interventional radiologist. Patients were categorized by body mass index (BMI): <25 kg/m2 (normal weight, n = 61), 25-29.9 kg/m2 (overweight, n = 40), and ≥30 kg/m2 (obese, n = 24). Most obese patients had Class I obesity (BMI, 30-34.9 kg/m2), with only 2 having a BMI of >35 kg/m2. Catheter-related adverse events within 1 year were recorded. The primary outcome was catheter failure (replacement, surgical repositioning, or PD discontinuation due to dysfunction). Death, transplantation, and renal recovery were considered competing events. Failure risk was assessed using the cumulative incidence function, and the effect of BMI categories was estimated by a Fine and Gray model. Adverse events were analyzed using a robust Poisson method.

RESULTS

Within 1 year, 36 catheter failures (28.8%) occurred, 3 patients died, and 7 underwent kidney transplantation before catheter failure. BMI was not significantly associated with catheter failure (subdistribution hazard ratios, overweight, 0.89 [95% CI, 0.45-1.78], and obese, 0.60 [95% CI, 0.23-1.59]). Sixty patients (48.0%) experienced at least 1 adverse event: 50.8%, 50.0%, and 37.5% in normal-weight, overweight, and obese patients, respectively (relative risk obese vs normal, 0.75 [95% CI, 0.41-1.36]).

CONCLUSIONS

Class I obesity was not associated with a higher risk of adverse events, supporting the safety and feasibility of percutaneous PD catheter insertion. However, these findings should be interpreted with caution given the limited sample size.