Bedside Seldinger Tenckhoff Catheter Insertion Without Fluoroscopy by Nephrologist: A Safe And Effective Method For Timely Insertion and Initiation of Kidney Replacement Therapy
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Keywords

Bedside Seldinger Tenckhoff catheter insertion
Peritoneal dialysis
PD catheter insertion-related peritonitis
Primary catheter dysfunction
Subumbilical Tenckhoff catheter insertion

Categories

Abstract

Introduction: Peritoneal dialysis (PD) is still underutilized despite being known as the most cost-effective dialysis modality. Until recently, our Tenckhoff catheter insertion requires the expertise of surgeon, anaesthetist, operating theater or fluoroscopic services in our center. This leads to long waiting time due to the scarcity of resources. To overcome this, we introduced bedside Seldinger Tenckhoff catheter (TC) insertion without fluroscopy. We aim to determine the safety, immediate and early complications following bedside TC insertion without fluroscopy

 

Methods: This is a retrospective study conducted in Hospital Queen Elizabeth, Sabah whereby all patients aged more than 18 years old who underwent bedside Seldinger TC insertion from 1 January 2020 – 31 December 2020 will be included. Demographic data, immediate and early complications following TC insertion were collected and analysed.

 

Results and Conclusion: There were 152 attempts of bedside Seldinger TC insertion with 149 TC inserted. Majority were female (65%) with mean age of 45.6 years old, body mass index of 24.6kg/m2 and mean TC insertion time was under 2 weeks. Main primary disease of end-stage kidney disease was diabetes (42%). Bleeding was the main immediate complication (n=6) where all were managed conservatively. The rates for PD catheter insertion-related peritonitis and primary catheter dysfunction following bedside TC insertion were 4.6% and 8%. To conclude, bedside TC insertion without fluroscopy allows timely insertion with low immediate and early complications. This allows patients with ESKD equitable access to kidney replacement therapy in a place with limited resources.

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References

26th Report of the Malaysian Dialysis and Transplant Registry 2018. https://www.msn.org.my/nrr/mdtr_report.jsp

Liu FX, Quock TP and Burkart J. Economic evaluations of peritoneal dialysis and hemodialysis: 2004-2012. F1000Research, vol. 2, no. 273, pp. 1-13,2013

Karopadi AN, Mason G, Rettore E, et al. Cost of peritoneal dialysis and haemodialysis across the world. Nephrology Dialysis Transplantation, vol 28 no 10, pp. 2553-2569, 2013

Grapsa E. Is the underutilization of peritoneal dialysis in relation to hemodialysis, as renal replacement therapy, justifiable worldwide? Yes or no. Hippokratia, vol 15, no. 1, pp. 13-15, 2011

Nephrology services operational policy. Medical Development Division. Ministry of Health Malaysia; 2010

Hooi LS, Mushahar L, Ong LM, et al. Renal Replacement Therapy. Clinical Practice Guidelines. 4th ed. Post Graduate Renal Society of Malaysia; 2017

Figueiredo A, Goh BL, Jenkins S et al. Clinical practice guidelines for peritoneal access. Perit Dia Int 2010:30:424-429

Goh BL, Ganeshadeva YM, Chew SE, et al. Does Peritoneal Dialysis Catheter Insertion by Interventional Nephrologists Enhance Peritoneal Dialysis Penetration? Siminars in Dialysis. 2008:561-566. DOI: 10.1111/j.1525-139X.2008.00478.x

Crabtree JH, Shrestha BM, Chow KM, et al. ISPD Guidelines Recommendations: Creating and Maintaining Optimal Peritoneal Dialysis Access in the Adult Patient 2019 Update. Perit Dial Int. 2019; 39(5):414-436. https://doi.org/10.3747/pdi.2018.00232

Al-Hwiesh AK. Percutaneous Peritoneal Dialysis Catheter Insertion by Nephrologist: A New, Simple, and Safe Technique. Perit Dial Int. 2014 34(2):204-211. doi: 10.3747/pdi.2012.00160

Jonny, Supriyadi R, Roesli R, et al. A Simple Tenckhoff Catheter Placement Technique for Continuous Ambulatory Peritoneal Dialysis (CAPD) Using the Bandung Mehod. International Journal of Nephrology. 2020 https://doi.org/10.1155/2020/4547036

George N, Alexander S, David VG, et al. Comparison of Early Mechanical and Infective Complications in First Time Blind, Bedside, Midline Percutaneous Tenckhoff Catheter Insertion with Ultra-Short Break-In Period in Diabetics and Non-Diabetics: Setting New Standards. Perit Dial Int. 2016;36(6):655-661. doi: 10.3747/pdi.2015.00097

Morad Z, Lee DG, Lim YN, et al. Peritoneal dialysis in Malaysia. Perit Dial Int 25:426-431, 2005

Li PKT, Chow KM, Cho Y, et al. ISPD peritonitis guideline recommendations: 2022 update on prevention and treatment. Perit Dial Int 2022; 42(2):110-153.

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