Ultrasound-Guided Percutaneous Peritoneal Dialysis Catheter Insertion for Urgent-Start Dialysis: Technique Description and Experience of a Single Center in Mexico City

Background Urgent-start peritoneal dialysis (PD) is a practical and useful form of renal replacement therapy (RRT). The main methods used for PD catheter placement include open/laparoscopic surgery as well as percutaneous puncture using the Seldinger technique. Placing PD catheters using ultrasound-guided percutaneous techniques could reduce some complications associated with the blind technique. Hence, using the Argyle Dialysis Catheter Kit, we adapted a technique for ultrasound-guided percutaneous placement of PD catheters. This study aims to describe our technique and outcomes in urgent-start PD. Materials and Methods Data were collected retrospectively on all patients who underwent PD catheter insertion by a nephrologist in urgent-start PD. All catheters were evaluated for complications from insertion until discharge from the hospital. Results This technique was performed in 74 patients with urgent-start RRT. The mean age of the subjects was 54.2 ± 14.6 years, and 40.5% were women. The mean body mass index (BMI) was 26.4 ± 5 kg/m 2 , and 23% of the patients had a BMI of > 30 kg/m 2 . A history of abdominal surgery was noted in 23%. No patient experienced tunnel infection or bowel perforation. Patients experienced transient PD dysfunction (21.6%), catheter migration (20.3%), leakage (8.1%), and peritonitis (13.5%). All complications were resolved before discharge. Conclusion Our adapted ultrasound-guided PD catheter placement technique with a prespecified kit was demonstrated to be safe and useful in patients with increased adiposity and/or a history of previous abdominal surgery. This procedure could reduce in-hospital costs for patients with end-stage kidney disease.