Catheter Event Rates in Medical Compared to Surgical Peritoneal Dialysis Catheter Insertion
Introduction: How patient, center, and insertion technique factors interact needs to be understood when designing peritoneal dialysis (PD) catheter insertion pathways. Methods: We undertook a prospective cohort study in 44 UK centers enrolling participants planned for first catheter insertion. Seque...
| Main Authors: | , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2023-12-01
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| Series: | Kidney International Reports |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2468024923015085 |
| _version_ | 1797404612830953472 |
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| author | James Fotheringham Ivonne Solis-Trapala Victoria Briggs Mark Lambie Keith McCullough Louese Dunn Andrew Rawdin Harry Hill Allan Wailloo Simon Davies Martin Wilkie |
| author_facet | James Fotheringham Ivonne Solis-Trapala Victoria Briggs Mark Lambie Keith McCullough Louese Dunn Andrew Rawdin Harry Hill Allan Wailloo Simon Davies Martin Wilkie |
| author_sort | James Fotheringham |
| collection | DOAJ |
| description | Introduction: How patient, center, and insertion technique factors interact needs to be understood when designing peritoneal dialysis (PD) catheter insertion pathways. Methods: We undertook a prospective cohort study in 44 UK centers enrolling participants planned for first catheter insertion. Sequences of regressions were used to describe the associations linking patient and dialysis unit-level characteristics with catheter insertion technique and their impact on the occurrence of catheter-related events in the first year (catheter-related infection, hospitalization, and removal). Factors associated with catheter events were incorporated into a multistate model comparing the rates of catheter events between medical and surgical insertion alongside treatment modality transitions and mortality. Results: Of 784 first catheter insertions, 466 (59%) had a catheter event in the first year and 61.2% of transitions onto hemodialysis (HD) were immediately preceded by a catheter event. Catheter malfunction was less but infection was more common with surgical compared with medical insertions. Participants at centers with fewer late presenters and more new dialysis patients starting PD, had a lower probability of a catheter event. Adjusting for these factors, the hazard ratio for a catheter event following insertion (medical vs. surgical) was 0.70 (95% confidence interval [CI] 0.43 to 1.13), and once established on PD 0.77 (0.62 to 0.96). Conclusion: Offering both medical and surgical techniques is associated with lower catheter event rates and keeps people on PD for longer. |
| first_indexed | 2024-03-09T02:57:33Z |
| format | Article |
| id | doaj.art-ee7e0ede082649959a3106fa87c914e7 |
| institution | Directory Open Access Journal |
| issn | 2468-0249 |
| language | English |
| last_indexed | 2024-03-09T02:57:33Z |
| publishDate | 2023-12-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Kidney International Reports |
| spelling | doaj.art-ee7e0ede082649959a3106fa87c914e72023-12-05T04:15:31ZengElsevierKidney International Reports2468-02492023-12-0181226352645Catheter Event Rates in Medical Compared to Surgical Peritoneal Dialysis Catheter InsertionJames Fotheringham0Ivonne Solis-Trapala1Victoria Briggs2Mark Lambie3Keith McCullough4Louese Dunn5Andrew Rawdin6Harry Hill7Allan Wailloo8Simon Davies9Martin Wilkie10Sheffield Kidney Institute, Sheffield Teaching Hospitals NHS Trust, Sheffield, UK; School of Health and Related Research, University of Sheffield, Sheffield, UKSchool of Medicine, Faculty of Medicine and Health Sciences, Keele University, Staffordshire, UKSheffield Kidney Institute, Sheffield Teaching Hospitals NHS Trust, Sheffield, UKSchool of Medicine, Faculty of Medicine and Health Sciences, Keele University, Staffordshire, UKArbor Research Collaborative for Health, Ann Arbor, Michigan, USASheffield Kidney Institute, Sheffield Teaching Hospitals NHS Trust, Sheffield, UKSchool of Health and Related Research, University of Sheffield, Sheffield, UKSchool of Health and Related Research, University of Sheffield, Sheffield, UKSchool of Health and Related Research, University of Sheffield, Sheffield, UKSchool of Medicine, Faculty of Medicine and Health Sciences, Keele University, Staffordshire, UKSheffield Kidney Institute, Sheffield Teaching Hospitals NHS Trust, Sheffield, UK; Correspondence: Martin Wilkie, Sheffield Kidney Institute, Sheffield Teaching Hospitals NHS Trust, Sheffield, UK.Introduction: How patient, center, and insertion technique factors interact needs to be understood when designing peritoneal dialysis (PD) catheter insertion pathways. Methods: We undertook a prospective cohort study in 44 UK centers enrolling participants planned for first catheter insertion. Sequences of regressions were used to describe the associations linking patient and dialysis unit-level characteristics with catheter insertion technique and their impact on the occurrence of catheter-related events in the first year (catheter-related infection, hospitalization, and removal). Factors associated with catheter events were incorporated into a multistate model comparing the rates of catheter events between medical and surgical insertion alongside treatment modality transitions and mortality. Results: Of 784 first catheter insertions, 466 (59%) had a catheter event in the first year and 61.2% of transitions onto hemodialysis (HD) were immediately preceded by a catheter event. Catheter malfunction was less but infection was more common with surgical compared with medical insertions. Participants at centers with fewer late presenters and more new dialysis patients starting PD, had a lower probability of a catheter event. Adjusting for these factors, the hazard ratio for a catheter event following insertion (medical vs. surgical) was 0.70 (95% confidence interval [CI] 0.43 to 1.13), and once established on PD 0.77 (0.62 to 0.96). Conclusion: Offering both medical and surgical techniques is associated with lower catheter event rates and keeps people on PD for longer.http://www.sciencedirect.com/science/article/pii/S2468024923015085catheter insertiondialysis accessperitoneal dialysis |
| spellingShingle | James Fotheringham Ivonne Solis-Trapala Victoria Briggs Mark Lambie Keith McCullough Louese Dunn Andrew Rawdin Harry Hill Allan Wailloo Simon Davies Martin Wilkie Catheter Event Rates in Medical Compared to Surgical Peritoneal Dialysis Catheter Insertion Kidney International Reports catheter insertion dialysis access peritoneal dialysis |
| title | Catheter Event Rates in Medical Compared to Surgical Peritoneal Dialysis Catheter Insertion |
| title_full | Catheter Event Rates in Medical Compared to Surgical Peritoneal Dialysis Catheter Insertion |
| title_fullStr | Catheter Event Rates in Medical Compared to Surgical Peritoneal Dialysis Catheter Insertion |
| title_full_unstemmed | Catheter Event Rates in Medical Compared to Surgical Peritoneal Dialysis Catheter Insertion |
| title_short | Catheter Event Rates in Medical Compared to Surgical Peritoneal Dialysis Catheter Insertion |
| title_sort | catheter event rates in medical compared to surgical peritoneal dialysis catheter insertion |
| topic | catheter insertion dialysis access peritoneal dialysis |
| url | http://www.sciencedirect.com/science/article/pii/S2468024923015085 |
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