Fluoroscopic Guided Peritoneal Dialysis Catheter Placement: An Analysis of Pelvic Catheter Positioning and Early Catheter Flow Dysfunction
Abstract
Fluoroscopic peritoneal dialysis catheter (FPDC) positioning has not been thoroughly evaluated. Using a retrospective cohort of adult patients who underwent FPDC insertion in London, Ontario (Feb 1, 2010 - Aug 1, 2017); we retrieved procedural radiographs measuring the level of intraabdominal radiocontrast to pubic symphysis (IRPS), and catheter tip to pubic symphysis (CTPS). The median (Q1-Q3) distance (millimeters) of IRPS was larger in females [35(25-44)] than males [28(19-37); P=0.001]; but this distance was not associated with variables: Age (years), BMI (Kg/m2), Race, PKD, abdominopelvic surgeries, in correlation/regression analyses. CTPS distance increased with BMI [(β; 95% Confidence Interval (CI); females: 0.79; 0.01,1.57; males: 1.08; 0.69,1.47)] and decreased with aging in males (-0.16; -0.29, -0.03). Predictors of early catheter dysfunction were assessed: CTPS, age, BMI, Race, ESKD, sex, break-in-period, abdominopelvic surgeries via backward-stepwise logistic regression, observing associations for higher BMI (Odds Ratio; 95% CI; 1.09; 1.01, 1.16), diabetic ESKD (0.39; 0.16, 0.93).