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Title: Postimplantation X-ray parameters predict functional catheter problems in peritoneal dialysis
Authors: Bammens, Bert ×
Peeters, Domien
Jaekers, Joris
Claes, Kathleen
Evenepoel, Pieter
Kuypers, Dirk
Meijers, Björn
Naesens, Maarten
Vanrenterghem, Yves
Monbaliu, Diethard #
Issue Date: Nov-2014
Publisher: Nature Pub. Group
Series Title: Kidney International vol:86 issue:5 pages:1001-6
Article number: 10.1038/ki.2014.203
Abstract: Functional catheter problems are a major challenge for peritoneal dialysis (PD) programs. Here we performed a retrospective single-center study of 110 consecutive patients receiving a first PD catheter (swan neck double-cuff Missouri curled catheters, open surgical technique). Using postimplantation X-ray, the following categories were defined: swan neck angle (posterioanterio view (PA): under 45°, 45-90°, over 90°), inclination (angle between intramural part of catheter and horizontal line; lateral view: greater than/equal to 30°, under 30°), and the position of silicone bead relative to spine (PA view: L1-2, L3-4, lower) and catheter tip (PA view: hypogastric, umbilical, subcostal). Covariates included demographics, body size, previous abdominal surgery, and abdominal wall hernias. During a mean follow-up of 36 months, the time to first functional catheter problem was significantly associated with both the swan neck angle and inclination. The need for surgical intervention was significantly associated with inclination only. Technique failure was not associated with any parameter. In multivariate analysis, inclination was the sole variable significantly associated with functional catheter problems (hazard ratio 3.65 [1.98-6.72]) and the need for surgical intervention (hazard ratio 2.86 [1.19-6.88]). Thus, our study defines a set of X-ray variables that predict functional PD catheter problems and can be used for troubleshooting in individual cases as well as for education and internal audit purposes.Kidney International advance online publication, 18 June 2014; doi:10.1038/ki.2014.203.
ISSN: 0085-2538
Publication status: published
KU Leuven publication type: IT
Appears in Collections:Laboratory of Abdominal Transplantation
Laboratory of Nephrology
× corresponding author
# (joint) last author

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