R KANAGARATNAM1, C CUI1, J FARQUHAR2, J MCCLUAND2, D HAHN2, A DURKAN2
1University Of Sydney, Camperdown, Australia, 2Department of Nephrology, The Children’s Hospital at Westmead, , Australia
Aims: To assess rates of PD catheter revision required within 1 month of insertion and to assess complication rates in the first year.
Background: Successful peritoneal dialysis (PD) is dependent upon effective catheter placement. There is limited data on early complication rates following catheter insertion in children.
Methods: A retrospective medical record review was conducted of double-cuff Tenckhoff PD catheters placed for proposed long-term renal replacement at The Children’s Hospital Westmead between 2007 and 2017. Patients undergoing catheter insertion for acute kidney injury were excluded. Multivariate regression analysis was used to look for risk factors for catheter failure.
Results : Forty three catheters were placed in 38 children. Median age at insertion was 7.1 years (range 0.1-16 years). Six catheters (14%) required revision within the first month due to impaired drainage from an ineffective catheter tip position. The median primary functional catheter lifetime was 322 days (3-893). In the first year, there were 20 episodes of peritonitis and 33 episodes of exit site infections (ESI) in 18 children. Six catheters were removed due to infection. There were 2 episodes of catheter migration requiring surgical intervention. There was no significant association between any complication and age, weight, sex, concurrent omentectomy or catheter insertion technique.
Conclusions: Approximately 1 in 7 children will require catheter revision within a month of insertion. Peritonitis or ESI are common but no significant associations were found between the method of catheter insertion and the likelihood of catheter revision, blockage or infection.
Roshana Kanagaratnam is a 3rd year medical student at UNSW. Her research interests within nephrology include paediatrics, best practice and shared decision making