Post insertion catheter care in peritoneal dialysis (PD) centres across Europe--Part 2: complication rates and individual patient outcomes.

Abstract

The first part of this report, which looked at centre policy, showed that there was no consensus on the best way to manage a patient in the rest period between PD catheter insertion and the first use of the catheter for dialysis. This paper intends to investigate if the differences in policy had any effect on complication rate and individual patient outcomes. Data were included from 298 patients of 49 participating centres. The results revealed a high rate of catheter related complications, with half of the patients having been treated for complications including leakage (29%), malfunction (23%) or infection (10%), and a quarter of patients having been hospitalised for catheter problems. Leakage was more frequently observed in lean and obese patients and if the catheter was only immobilized for a short time period. Diabetes, having constipation at first use and having rested for less than 6 hours after catheter insertion were significant risk factors for malfunction. Infection seemed to be related to the type of catheter used and hygienic precautions (not significant) and showed a significant relationship with the frequency of dressing changes. There is still an important lack of evidence on which to develop an optimal protocol for PD catheter insertion and care before first use.