A GROUNDBREAKING study comparing non-surgical (medical) insertion of abdominal catheters for peritoneal dialysis to traditional surgical methods has unveiled promising results, suggesting that the medical approach is at least as safe and effective, with added convenience for patients.
The research, which followed 769 kidney patients undergoing their initial abdominal catheter insertion, brings much-needed reassurance to individuals opting for peritoneal dialysis, a common treatment for kidney failure alongside haemodialysis.
Peritoneal dialysis utilises the peritoneum lining of the abdomen to remove waste products and fluids, necessitating the permanent insertion of a catheter into the abdominal space. Traditionally, this procedure has been performed surgically under general anaesthesia. However, with the rise in demand and constraints in surgical resources, medical insertion has gained popularity in recent years.
Conducted across 44 dialysis centres in the UK between 2015–2017, the study analysed outcomes from both surgical (58%) and medical (42%) insertion procedures. Results indicated that patients undergoing medical insertion experienced fewer ‘safety events’, such as catheter removals, leaks, and infections, compared to those opting for surgical insertion (55% versus 63%).
Furthermore, the incidence of infections was significantly lower among medical insertion recipients (3% versus 11%). Although surgical insertion patients required catheter removal slightly less frequently (18% versus 22% for medical insertion patients), the overall safety and efficacy of the medical approach were evident.
Importantly, the study underscored the need for individualised patient care, highlighting that medical insertions may not be suitable for all candidates. Factors such as prior abdominal surgery significantly influenced the choice of insertion method.
Reference:
Fotheringham J et al. Catheter event rates in medical compared to surgical peritoneal dialysis catheter insertion. Kidney Int Rep. 2023;DOI:10.1016/j.ekir.2023.09.015.
