Predictive factors for Peritoneal Dialysis Catheter Survival: a ten-year single center study

Abstract

Introduction and Objectives: Timely insertion and adequate management of peritoneal dialysis catheter (PDC) related complications are crucial for the success of Peritoneal Dialysis. The aim of this study was to review the peritoneal dialysis catheter outcomes at our center, identifying factors that influence catheter survival.

Materials and Methods: A retrospective study was conducted on 146 PD patients who received their first PDC between August/ 2012 and July/2022. The mean follow-up was 26.5 ± 22.7 months.

Results: Mean age was 55.1 ± 16.6 years, and 58.2% were male. Peritonitis occurred in 75 patients (51.4%), with 26 (34.7%) requiring catheter removal. Mechanical complications were observed in 66 patients (45.2%), with 16 requiring catheter removal. Catheter survival at 12, 24, and 36 months was 80.2%, 72.4%, and 61.6%, respectively. Non-infectious complications (p=0.006) and peritonitis episodes (p=0.017) were associated with higher rate of PDC-associated removal. In the multivariate analysis, non-infectious complications were the only independent variable significantly associated with catheter survival (Hazard ratio 2.53; 95% CI 1.383–4.624). No association was found between PDC survival and age, diabetic status, obesity, prior kidney transplant, previous abdominal surgery, or method of catheter insertion.

Conclusions: Despite the significant number of infectious complications, including peritonitis, these did not result in a substantial decrease in catheter survival in the multivariate analysis. These findings emphasize the importance of effectively managing non-infectious complications to ensure successful and long-term use of PDCs. Preventive measures, such as omentectomy simultaneously with PDC implantation, may be considered on a case-by-case basis.