EXPANDING THE SCOPE OF INTERVENTIONAL NEPHROLOGY: PD CATHETER PLACEMENT AT UMC LJUBLJANA

 

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EXPANDING THE SCOPE OF INTERVENTIONAL NEPHROLOGY: PD CATHETER PLACEMENT AT UMC LJUBLJANA

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Jernej
Pajek
Jernej Pajek jernej.pajek@kclj.si UMC Ljubljana Nephrology Ljubljana Slovenia *
Bojan Knap bojan.knap@kclj.si UMC Ljubljana Nephrology Ljubljana Slovenia -
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To retrospectively evaluate the outcomes of peritoneal dialysis (PD) catheter insertions performed by nephrologists and to assess the impact of this shift in access management on PD uptake at the University Medical Centre (UMC) Ljubljana between 2022 and 2024.

We performed a retrospective review of all PD catheter insertions conducted by nephrologists from June 2022 to December 2024. Insertion techniques evolved during the study period, beginning with percutaneous placement under local anesthesia and transitioning to an open surgical mini-laparotomy approach. Regional anesthesia was introduced in late 2023 to enhance procedural safety and patient comfort. We analyzed patient demographics, procedural data, early and late catheter function, and complications. Changes in PD utilization during the study period were reviewed to assess the broader impact on renal replacement therapy (RRT) delivery.

A total of 37 PD catheters were placed by nephrologists. Among 37 patients, 29 (78%) were male, with a median age of 56 years and median BMI of 24.5. Diabetic nephropathy (31%) and IgA nephropathy (28%) were the leading causes of kidney failure. Seventy percent initiated PD as their first RRT modality, and 15% had prior abdominal surgery.

Thirty-four catheters were placed via mini-laparotomy and three using a percutaneous modified Seldinger technique. Thirteen procedures were performed under regional anesthesia; the remainder under local. Immediate catheter function was achieved in 36 patients (95%), with one early complication requiring laparoscopic revision. One-year catheter survival was 95%, with no major complications. Two cases of tip migration occurred in the percutaneous group.


Nephrologist-led PD catheter insertion is safe, effective, and enables timely PD initiation. It has significantly increased PD utilization at our center by over 70%, improving access to home dialysis. This model supports greater autonomy in RRT planning and can be adopted by other centers to expand PD programs. This abstract was previously presented at the EuroPD 2025 conference in Valencia.


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