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Peritoneal dialysis has been widely demonstrated to be an optimal and well-tolerated therapy in candidate patients. Currently, in a general hospital, like ours, surgical waiting times are longer than desired. It has been shown that the time taken to establish renal replacement therapy is directly related to the increase in morbidity and mortality. The percutaneous technique is a viable, safe, functional option that even allows the addition of patients with anesthetic contraindications, which allows for timely initiation of renal replacement therapy, thereby improving morbidity and mortality, in addition to offering economic advantages to the institute.
A retrospective study was carried out on patients who underwent peritoneal dialysis catheter placement with a percutaneous technique. In total 86 cases with stage 5 chronic kidney disease, of which 78 were patients newly admitted to peritoneal dialysis and the remaining 8 with a change of modality to peritoneal dialysis; all in a period of 6 years until October 1, 2023; at the Morelia regional hospital, ISSSTE. COVIDIEN brand catheters were used, 57cm pigtail Argyle model, with 2 bearings. In all cases they were placed by a single nephrologist and a general surgeon in the patient's bed.
The causes that conditioned end-stage chronic kidney disease are reviewed, criteria for starting renal replacement, functionality of the peritoneal access is evaluated immediately and 30 days later, as well as main complications.
Of the 86 patients, the minimum age was 22 years and the maximum age was 82 years, with an average age of 64 years. In sex we find 41 men and 45 women. Of the total number of patients, 88% had diabetic nephropathy as the cause of their kidney disease; the rest other etiologies.
In all cases, the catheter was placed on the same day of admission and was used immediately; thus showing its multiple advantages compared to other methods.
The data reflected in this study forcefully expose the multiple advantages of the percutaneous technique for the placement of the peritoneal dialysis catheter, in which the early start of peritoneal dialysis stands out, the reduction in waiting time and thus the reduction of the days of hospital stay, the complications added to this, decrease in the number of patients admitted to hemodialysis; Similarly, a reduction in costs for the hospital was observed.
Discussion: During the time of the study, 4 more catheters were placed with this technique in patients with acute kidney injury; all with remission of kidney failure, which made the 30-day evaluation impossible. However, it is important to emphasize that it is also a feasible alternative for use in patients with acute kidney injury.
All participants in this project declare themselves to have no conflict of interest.