ONE -YEAR OUTCOMES OF PERCUTANEOUS CONTINUOUS AMBULATORY PERITONEAL DIALYSIS CATHETER INSERTION BY NEPHROLOGISTS: INITIAL EXPERIENCE FROM SRI LANKA

E-Poster

https://storage.unitedwebnetwork.com/files/1099/7a4a1a8dc3a837a31edfee22a50918bc.pdf

Abstract Title

First Name *

Udana

Last Name *

Ratnapala

Co-author 1

Hiranya Wijesekara hiranyawijesekara93@gmail.com Teaching Hospital, Badulla Medicine Badulla

Co-author 2

Chaminda Sirisena k.s.c.sirisena@gmail.com Teaching Hospital, Badulla Nephrology Badulla

Co-author 3

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Introduction

Continuous Ambulatory Peritoneal Dialysis (CAPD) with intraperitoneal placed catheter is an established effective mode of renal replacement therapy (RRT). Currently, CAPD catheters placement is done using either percutaneous or surgical technique. Percutaneous method is less invasive and avoids need of general anaesthesia, surgical expertise and setting. This study was conducted to measure the one year outcomes of percutaneous CAPD catheter insertions performed by a nephrology team; the first experience from Sri Lanka.

Methods

We retrospectively studied 96 patients in two centers , who underwent percutaneous CAPD catheter insertion over two years with a follow up period of minimum one year. Catheter was placed using modified seldinger technique under local anaesthesia with ultrasound guidance. Data on demographics, comorbidities, details on previous modes of RRT, and complications following CAPD catheter insertions were extracted.

Results

The majority were males (78.1%) with the median age of 56 years. Median BMI was 24.6 kg/m2 with hypertension (87.5%) and diabetes mellitis (53.1%) being commonest comorbidities.

Majority were on haemodialysis (HD) (85.4%) prior to CAPD catheter insertion. The common reasons for opting CAPD were to avoid hospital visits for HD ( 54.2%) followed by insufficient cardiovascular fitness(26%). During the follow up of one-year,85.4% were free of complications. The common non-infectious complications were catheter removal( 12.5%), visceral injury (4.2%), primary insertion failure (4.2%) and catheter dysfunction (2.1%). Pre-training peritonitis was present in 2.1% with an overall peritonitis rate of 0.4 episodes per patient year. There was no significant association between catheter-related complications and gender (p=.68), previous abdominal surgery (0.54), diabetes mellitus (p=.84), and hypertension (p=.46). The one year CAPD catheter survival was 92%,

Conclusions

One year outcomes of percutaneous CAPD catheter insertion by nephrologists were efficacious and safe with low complication rates. Hence, CAPD catheter insertion by well-trained nephrologists should be encouraged. Further studies comparing percutaneous versus surgical catheter placement is warranted.

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