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Impact of preoperative factors on catheter position in peritoneal dialysis: a prospective cohort study

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Abstract

Background

Peritoneal dialysis (PD) catheter malposition is one of the complications of renal replacement therapy. This study aimed to determine the preoperative factors that cause PD catheter malposition.

Methods

The prospective cohort study included patients who underwent PD catheter insertion surgery and had preoperative and postoperative computed tomography scans. We compared preoperative and intraoperative factors between the lower depth catheter group (group L) and upper depth catheter group (group U), and preoperative and intraoperative factors between the posterior catheter group (group P) and anterior catheter group (group A). In addition, PD catheter obstruction requiring surgical intervention in each group was followed up for 1 year.

Results

A total of 150 patients were categorized into groups L (n = 77) and U (n = 73), or groups P (n = 107) and A (n = 43). Body mass index (BMI; P = 0.02), subcutaneous fat area (P = 0.02), and rate of previous abdominal surgery (P = 0.01) were significantly lower in group L than in group U. In terms of anterior catheter position, females had more-anterior catheter positions. The time to PD catheter obstruction requiring surgical intervention (P = 0.03) was significantly lower in group U than in group L.

Conclusions

High BMI, high subcutaneous fat area, high subcutaneous fat thickness, and previous abdominal surgery were identified as preoperative factors that cause the PD catheter to have an upper depth. Female sex was a preoperative influencing factor for the anterior PD catheter position.

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Acknowledgements

We would like to acknowledge PD nurses Yukari Kikuchi and Sanae Matsuura, Nurse Practitioner Masafumi Satake, radiological technologist Kentaro Takahashi, and all PD nurses and radiology technologists at Tohoku Medical and Pharmaceutical University Hospital for their help in data collection and image creation.

Funding

This work was supported by JSPS/MEXT KAKENHI Grant Nos. 19H03677 and 19K21596.

Author information

Authors and Affiliations

  1. Division of Nephrology and Endocrinology, Tohoku Medical and Pharmaceutical University, Sendai, Japan

    Kento Hoshino, Takuo Hirose, Ryo Tajima, Toshihiro Sato, Yuka Miyake, Tsugumi Fukunaga, Toshiko Kato, Akari Endo, Takayuki Seki, Shingo Nakayama, Ikuko Oba-Yabana, Hannah Nakamura, Junichi Tani & Takefumi Mori

  2. Department of Nephrology, Japan Self-Defense Forces Sendai Hospital, Sendai, Japan

    Kento Hoshino, Yuka Miyake & Tsugumi Fukunaga

  3. Department of Urology, Tohoku Medical and Pharmaceutical University, 1-15-1 Fukumuro, Miyagino-ku, Sendai, Miyagi, 983-8536, Japan

    Go Anan

  4. Division of Integrative Renal Replacement Therapy, Tohoku Medical and Pharmaceutical University, Sendai, Japan

    Takuo Hirose, Seiko Yamakoshi & Takefumi Mori

Authors
  1. Kento Hoshino
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  2. Go Anan
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  3. Takuo Hirose
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  4. Seiko Yamakoshi
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  5. Ryo Tajima
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  6. Toshihiro Sato
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  7. Yuka Miyake
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  8. Tsugumi Fukunaga
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  9. Toshiko Kato
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  10. Akari Endo
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  11. Takayuki Seki
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  12. Shingo Nakayama
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  13. Ikuko Oba-Yabana
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  14. Hannah Nakamura
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  15. Junichi Tani
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  16. Takefumi Mori
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Contributions

KH and GA conceptualized and designed the study. KH, GA, RT, TS, YM, TF, TK, AE, TS, SN, IOY, HN, JT, and TM participated in the patients’ medical treatment. KH, GA, SY, RT, TS, YM, TF, TK, AE, and TS collected data; and GA performed the statistical analysis. KH drafted the first version of the manuscript, and GA, TH, and TM helped draft the revised manuscript. All authors have read and approved this submission.

Corresponding author

Correspondence to Go Anan.

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Conflict of interest

The Division of Integrative Renal Replacement Therapy (T.H. and T.M.) is financially supported by Chugai Pharmaceutical Co., Ltd., Terumo Corporation, and JMS Co., Ltd. All other authors have no conflicts of interest.

Ethical approval

This study was conducted in accordance with the principles of the latest version of the Declaration of Helsinki. This prospective cohort study was approved by the ethics committee of Tohoku Medical and Pharmaceutical University Hospital, Japan (Protocol 2016–2-008).

Informed consent

Written informed consent was obtained from all the patients.

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Hoshino, K., Anan, G., Hirose, T. et al. Impact of preoperative factors on catheter position in peritoneal dialysis: a prospective cohort study. Clin Exp Nephrol 26, 835–841 (2022). https://doi.org/10.1007/s10157-022-02214-z

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  • DOI: https://doi.org/10.1007/s10157-022-02214-z

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