Abstract No. 441 Eventual outcomes of patients undergoing peritoneal dialysis catheter by interventional radiologist: a large single-institution 2-year observational study

Abstract

Patients with end-stage renal disease may use peritoneal dialysis (PD) for convenience and flexibility. However, PD catheters may have associated adverse outcomes, including discomfort, inadequate dialysis, malfunction, and infection. Some of them may transition to Hemodialysis or possibly get a kidney transplant during their lifetime. Our study sought to determine the outcomes of patients who had PD catheters placed by Interventional radiologists over a 2-year period. A database was generated of patients who had received PD catheters over a 2-year period. Demographic and pre-PD catheter placement data was collected, including ESRD etiology, preexisting RRT modality, and baseline creatinine. Outcome data was gathered through clinical record review, including infection incidence, time to HD conversion (if applicable), and time to transplant. Patients who had inconsistent records or were lost to follow-up were excluded from analysis. A total of 80 patients who received PD catheters from March 1, 2014, to December 21, 2016, were included in analysis. Approximately 36.3% (29/80) patients had preexisting RRT with HD prior to PD catheter placement. 25% (20/80) patients had at least one episode of PD catheter-associated infection, with peritonitis accounting for 85% (17/20) of infection. All reported cases of infection occurred after 30 days of PD catheter placement, with a median time-to-infection of 11.6 months. Approximately 42.5% (34/80) of PD patients transitioned to HD, with tunneled catheter placement accounting for the most common post-PD RRT modality. Infection and PD failure accounted for the first and second most cited reasons for PD catheter removal at 29.7% and 27.0%, respectively. 25% of patients underwent eventual successful renal transplant. PD catheter related infection, most specifically peritonitis, remains a serious complication of PD, leads to hospitalization, PD catheter removal, or possible conversion to HD. Infection remains the most common cause of PD catheter removal (excluding transplant). All cases of infection occurred 30 days post-PD catheter placement, suggesting that infection is not related to IR procedure but remains an important cause for conversion to HD.