Diabetes Is the Most Critical Risk Factor of Adverse Complications After Peritoneal Dialysis Catheter Placement

Hsiao-Huang Chang; Ching-Hsiang Chang; Chen-Yuan Hsiao; Shih-Yi Kao; Jinn-Yang Chen; Tien-Hua Chen; Pei-Jiun Tsai

doi:10.3389/fmed.2021.719345

Diabetes Is the Most Critical Risk Factor of Adverse Complications After Peritoneal Dialysis Catheter Placement

Front Med (Lausanne). 2021 Oct 27:8:719345. doi: 10.3389/fmed.2021.719345. eCollection 2021.

Authors

Hsiao-Huang Chang^{1

2}, Ching-Hsiang Chang³, Chen-Yuan Hsiao^{2

4

5}, Shih-Yi Kao⁶, Jinn-Yang Chen⁷, Tien-Hua Chen^{8

9

10}, Pei-Jiun Tsai^{8

9

11}

Affiliations

¹ Division of Cardiovascular Surgery, Department of Surgery, Veterans General Hospital, Taipei, Taiwan.
² School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.
³ Nursing Department, Veterans General Hospital, Taipei, Taiwan.
⁴ Division of Cardiovascular Surgery, Department of Surgery, Taipei Medical University Hospital, Taipei, Taiwan.
⁵ Department of Biology and Anatomy, National Defense Medical Center, Taipei, Taiwan.
⁶ Ten-Chan General Hospital Zhongli, Taoyuan, Taiwan.
⁷ Division of Nephrology, Department of Medicine, Veterans General Hospital, Taipei, Taiwan.
⁸ School of Medicine, Institute of Anatomy and Cell Biology, National Yang Ming Chiao Tung University, Taipei, Taiwan.
⁹ Department of Surgery, Trauma Center, Veterans General Hospital, Taipei, Taiwan.
¹⁰ Division of General Surgery, Department of Surgery, Veterans General Hospital, Taipei, Taiwan.
¹¹ Department of Critical Care Medicine, Veterans General Hospital, Taipei, Taiwan.

Abstract

Introduction: Peritoneal dialysis (PD) is a kind of renal replacement therapy for end-stage renal disease (ESRD). While PD has many advantages, various complications may arise. Methods: This retrospective study analyzed the complications of ESRD patients who received PD catheter implantation in a single medical center within 15 years. Results: This study collected 707 patients. In the first 14 days after PD implantation, 54 patients experienced bleeding complications, while 47 patients experienced wound infection. Among all complications, catheter-related infections were the most common complication 14 days after PD implantation (incidence: 38.8%). A total of 323 patients experienced PD catheter removal, of which 162 patients were due to infection, while 96 were intentional due to kidney transplantation. Excluding those whose catheters were removed due to transplantation, the median survival of the PD catheter was 4.1 years; among them, patients without diabetes mellitus (DM) were 7.4 years and patients with DM were 2.5 years (p < 0.001). Further, 50% probability of surviving was beyond 3.5 years in DM patients with HbA1CC < 7 and 1.6 years in DM patients with HbA1C <7 (p ≥ 0.001). Conclusions: Catheter-related infections were the most common complications following PD catheter implantation. DM, especially with HbA1C ≥7, significantly impacted on the catheter-related infection and the survival probability of the PD catheter.

Keywords: catheter; diabetes; end-stage renal disease (ESRD); infection; peritoneal dialysis.