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Peritoneal Dialysis Catheter Insertion by the Nephrologist

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Applied Peritoneal Dialysis

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Abstract

Timely, quality peritoneal dialysis (PD) catheter placement is the key to PD technique survival and a successful PD program. Percutaneous PD catheter insertion can be performed under local anesthetic by an interventional nephrologist or radiologist. This procedure may be done under ultrasound, fluoroscopic, or peritoneoscopic guidance to improve visibility and safety.

The major advantage of percutaneous PD catheter insertion is its simplicity in terms of logistics and staff resources. However, the reduced visibility increases the risk of catheter malposition and damage to intra-abdominal viscera. Meticulous patient selection and patient preparation are therefore critical. Several technique variations exist, all of which are followed by fastidious early catheter care. In this chapter, we describe a modified Seldinger approach under real-time ultrasound guidance. With this careful approach, bowel perforation is observed in less than 1% of procedures.

A successful percutaneous PD catheter insertion program can have a positive impact on PD utilization in high- and low-resource settings alike. It is incumbent upon all interventional nephrologists to review their catheter outcomes in a transparent way and continually strive for quality improvement. Specific recommendations for operator training, local audit, and program collaboration are included.

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Authors and Affiliations

  1. University Hospital Network, Toronto, ON, Canada

    Claire Kennedy & Rory McQuillan

Authors
  1. Claire Kennedy
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  2. Rory McQuillan
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Corresponding author

Correspondence to Rory McQuillan .

Editor information

Editors and Affiliations

  1. CORE Kidney Health Program, Department of Medicine, Division of Nephrology, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA

    Anjay Rastogi

  2. University of Illinois at Chicago, College of Medicine, Chicago, IL, USA

    Edgar V. Lerma

  3. Division of Nephrology, University of Toronto, University Health Network/Toronto General Hospital, Toronto, ON, Canada

    Joanne M. Bargman

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Kennedy, C., McQuillan, R. (2021). Peritoneal Dialysis Catheter Insertion by the Nephrologist. In: Rastogi, A., Lerma, E.V., Bargman, J.M. (eds) Applied Peritoneal Dialysis. Springer, Cham. https://doi.org/10.1007/978-3-030-70897-9_9

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  • DOI: https://doi.org/10.1007/978-3-030-70897-9_9

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-70896-2

  • Online ISBN: 978-3-030-70897-9

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