Study of early complications associated with peritoneal dialysis catheters: an analysis of the New Zealand Peritoneal Dialysis Registry data

Abstract

Introduction: Early peritoneal dialysis catheter (PDC)-related complications are frequent and make an important contribution to long-term PD survival. We aimed to analyse the incidence and specific causes of early PDC-related complications.

Methods: This study was conducted from January 2001 to December 2012, utilising the New Zealand PD Registry (NZPDR) data. The objectives of this study were to analyse the incidence and causes of PDC-related complications within 4 weeks and 3 months of insertion. A logistic regression analysis was conducted to analyse any demographic or clinical risk factors of early PDC-related complications.

Results: Of the 2573 PDC insertions during this period, majority 88% were surgically inserted. The number of complication within 4 weeks ranged from minimum of 20% to a maximum of 34% annually, with infections and flow dysfunctions leading the causes. There has been a minor drop in the infection rates from 19 to 16% (p = 0.21), and flow dysfunction from 12 to 9% (p = 0.16), from 2001 to 2012. A reduced odds of early complication was noted in elderly individuals above 60 years age, with odds ratio of (OR) of 0.73 (95% CI 0.53-0.99), while as higher odds of early complications were recorded in female gender, OR 1.41 (95% CI 1.06-1.88). Of the 10% of patients who failed to initiate PD within 90 days, flow dysfunction contributed to 32%, followed by infectious and surgical causes in 16% and 15%, respectively. The median time from insertion of PDC to initiation of PD was 17 days (interquartile range of 14-24 days) CONCLUSIONS: Improvements in PDC insertion techniques and reduction in infection rates may result in improvements in long-term PD technique survival.

Keywords: Peritoneal dialysis; Technique failure.