Introduction: Peritoneal dialysis (PD) guidelines recommend a 14-day break-in period after catheter placement, yet this period could be shortened with new insertion techniques. Methods: We conducted a prospective cohort study to compare percutaneous vs. surgical catheter insertion in a newly established PD program. The break-in period was intentionally shortened to <24 h to start PD almost immediately. Results: We included 223 subjects who underwent percutaneous (34%) or surgical (66%) catheter placement. Compared to the surgical group, the percutaneous group had a higher proportion of early dialysis initiation within 24 h (97% vs. 8%, p < 0.001), similar successful initiation rates (87% vs. 92%, p = 0.34), and shorter lengths of stay (12 [9–18] vs. 18 [14–22] days, p < 0.001). Percutaneous insertion increased the likelihood of successful PD initiation within 24 h (OR 74, 95% CI 31–182), without increasing major complications. Conclusion: Percutaneous placement could represent a cost-effective and efficient technique to shorten break-in periods.
CITATION STYLE
Chávez-Chávez, H. E., Hernández-Paredes, E. N., Cojuc-Konigsberg, G., Vargas-Rodríguez, C., Díaz-Canchola, L. M., Vergara-Zavala, O., … Ramirez-Sandoval, J. C. (2023). Optimizing peritoneal dialysis initiation: A comparative cohort study of catheter placement methods for shortening break-in periods. Therapeutic Apheresis and Dialysis, 27(5), 909–917. https://doi.org/10.1111/1744-9987.14000
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