Original Research
Percutaneous placement of peritoneal dialysis catheters in resource-limited developing countries as an alternative to conventional placement methods
Submitted: 03 August 2014 | Published: 29 April 2015
About the author(s)
Hendrik R. van den Berg, Registrar in Radiology, University of the Free State, Bloemfontein, South AfricaSuzanne O'Hagan, Medical Officer in Radiology, Kimberley Provincial Hospital, South Africa
Delme Hurter, Department of Radiology, Kimberley Provincial Hospital, South Africa
Abstract
Method: We conducted a retrospective study on 25 patients who had their PD catheters inserted between January 2009 and May 2013. Medical records were reviewed for demographic and clinical information as well as type and frequency of early (within 30 days) and late (between 30 days and one-year) complications related to the PD catheter. Early complication types and frequencies were then compared with similar internationally published data. The overall peritonitis rate, in terms of episodes per patient-year, was calculated and compared with international recommendations, and our one-year catheter survival rate was calculated using the Kaplan Meier method and compared with similarly calculated international studies.
Results: The study group comprised 16 male and 9 female patients with a median age of 44 years. Hypertension was the primary cause of end-stage renal disease (ESRD), and was found in 10 (40%) patients. Our early exit site infection rate of 12% was slightly higher than that found in the literature. Literature varies on the overall infection rates; however, our overall peritonitis rate of 0.75 episodes per patient-year was higher than that recommended by the International Society of Peritoneal Dialysis. This finding might be attributed to the lower socio-economic grouping of our patients and the small number in the study group. All but two peritonitis cases were successfully treated with antibiotics, and we had no major procedure-related complications. Our early peritonitis rate of 8%, as well as the other early complication types and rates, and our one-year catheter survival rate of 84%, compared favourably with international studies.
Conclusion: Percutaneous PD catheter placement under conscious sedation with the aid of ultrasound and fluoroscopy is a sound alternative to conventional methods in the resourcelimited developing world.
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Crossref Citations
1. Peritoneal Dialysis in Austere Environments: An Emergent Approach to Renal Failure Management
Chad Gorbatkin, John Bass, Fredric Finkelstein, Steven Gorbatkin
Western Journal of Emergency Medicine vol: 19 issue: 3 first page: 548 year: 2018
doi: 10.5811/westjem.2018.3.36762