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


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



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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