4:20 PM Abstract No. 239 Outcomes of Elective Versus Urgent-Start Peritoneal Dialysis Catheter Placement

Laparoscopic and radiologic placement techniques of peritoneal dialysis catheter (PDC) can be used with urgent-start and elective peritoneal dialysis (PD). The objective of this study is to compare the outcomes of elective versus urgent-start use of the PDC regardless of the technique used for placement. We retrospectively reviewed the medical records of patients who had their first peritoneal dialysis catheter placed and used between January 2005 and December 2015. The patients were divided into two groups; group A and B were elective and urgent-start PD respectively. The primary endpoint was complication-free catheter survival at 90 and 365 days. Secondary endpoints were catheter survival at 90 and 365 days, median days-to-first complication and median days-to-catheter removal. The study included 240 patients, 134 females (56%), median age was 54.7 years (IQR = 41.3-64.3), and median BMI was 28.3 (IQR = 24.1-34.5). There were 211 patients in group A. There was no significant difference in the baseline characteristics of both groups. The 90 and 365 days complication-free catheter survival and the overall catheter survival at 365 days were not different between the two groups (69.7%, 52.4% and 51.7% for group A, 65.5%, 51.7% and 33.3% for group B, p = 0.64, 0.94 and 0.07 respectively). Catheter survival at 90 days was significantly higher for group A compared to group B (87% and 70% respectively, p = 0.04). Catheter leak was significantly lower in group A (3.3%) compared to group B (13.8%) (p = 0.03) and occurred more in the radiologic technique compared to the laparoscopic technique (p = 0.05). There was a trend towards higher catheter malfunction in group A (28.4%) compared to group B (17.2%), which was not significant (p = 0.20). The median days until removal were 376 and 197 days respectively which was not significant (p = 0.07). Apart from catheter leak, there was no significant difference in the complication rate of PDC placed for elective versus urgent-start PD. The 90 day overall catheter survival was significantly better for elective PDC and catheter removals occurred earlier in the urgent-start PDC.