Journal of vascular and interventional radiology : JVIR · 2025
Outcomes and Risk Factors Following Tunneled Peritoneal Dialysis Catheter Insertion by Interventional Radiologists.
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Karthikeyan Rithvik, Singh Ileesha, Hadigal Satvik, Picus Daniel, Mani Naganathan
Аннотация
PURPOSE: To assess whether patient factors, including age, sex, and diabetic involvement, are associated with adverse events during the course of tunneled peritoneal dialysis (PD) catheter placed by interventional radiology (IR).
MATERIALS AND METHODS: This retrospective cohort study examined patients (n = 104) who required kidney replacement and underwent their initial tunneled PD catheter insertion procedure by the IR team at an academic teaching hospital between July 2021 and May 2024. An adverse event during the course of PD was defined as the first episode of peritonitis, catheter dysfunction, catheter insufficiency, catheter intolerance, or death. Inferential analyses included logistic regression and Cox proportional-hazards models to assess potential risk factors.
RESULTS: Of the included patients, 32 (30.8%) experienced at least 1 episode of peritonitis during their PD course, with 6 patients experiencing multiple episodes. Diabetic involvement had the highest hazard ratio of 1.59 (95% confidence interval, 0.92-2.75; P = .094), suggesting a potential association with the occurrence of adverse events. Staphylococcus infections appeared to be more common in late-onset peritonitis (P = .03).
CONCLUSIONS: Peritonitis remains a major adverse event of PD despite current best practices. Moreover, the differences in the causative organism based on the time of episode warrant further attention, especially in terms of its management and empiric antibiotics. Diabetic involvement also remains a significant risk for the occurrence of an adverse event in the course of the inserted catheter. A deeper understanding of the complexities associated with PD is essential to achieving better clinical outcomes.
MATERIALS AND METHODS: This retrospective cohort study examined patients (n = 104) who required kidney replacement and underwent their initial tunneled PD catheter insertion procedure by the IR team at an academic teaching hospital between July 2021 and May 2024. An adverse event during the course of PD was defined as the first episode of peritonitis, catheter dysfunction, catheter insufficiency, catheter intolerance, or death. Inferential analyses included logistic regression and Cox proportional-hazards models to assess potential risk factors.
RESULTS: Of the included patients, 32 (30.8%) experienced at least 1 episode of peritonitis during their PD course, with 6 patients experiencing multiple episodes. Diabetic involvement had the highest hazard ratio of 1.59 (95% confidence interval, 0.92-2.75; P = .094), suggesting a potential association with the occurrence of adverse events. Staphylococcus infections appeared to be more common in late-onset peritonitis (P = .03).
CONCLUSIONS: Peritonitis remains a major adverse event of PD despite current best practices. Moreover, the differences in the causative organism based on the time of episode warrant further attention, especially in terms of its management and empiric antibiotics. Diabetic involvement also remains a significant risk for the occurrence of an adverse event in the course of the inserted catheter. A deeper understanding of the complexities associated with PD is essential to achieving better clinical outcomes.