Effect of embedded catheter implantation on postoperative kidney function: the influence of kidney function in embedded catheter implantation

Abstract Background After the induction of peritoneal dialysis (PD), there is a risk of catheter-related infections and catheter dysfunction. To prevent infection, a surgical approach known as embedded catheter implantation has been developed. An advantage of this technique is that it allows PD to be planned. It has also been found to suppress the kidney function decline. Methods We evaluated the rate of kidney function decline before and after embedded catheter implantation using the estimated glomerular filtration rate (eGFR) slope. This retrospective cohort study included 51 patients undergoing peritoneal dialysis by embedded catheter implantation at five hospitals between 2015 and 2024. The eGFR slopes before and after surgery were compared. Results The median age of the study population was 60.0 years (interquartile range, 47.5–67.0 years), and 66.7% were male ( n = 34). Diabetic nephropathy was the most frequent primary kidney disease (33.0%, n = 17). The postoperative eGFR slope (mL/min/1.73 m 2 /year) was significantly lower than observed preoperatively (8.2 [5.0–13.8] versus 4.1 [1.5–7.0], p < 0.01). There were no differences between the preoperative and postoperative hemoglobin and albumin levels. Embedded catheter implantation may suppress the rate of kidney function decline and extend the time to dialysis initiation. Conclusions Embedded catheter implantation may suppress the rate of kidney function decline and extend the time to dialysis initiation in patients with advanced chronic kidney disease. This effect could be partially attributed to psychological or behavioral factors; however, further studies are warranted to confirm the underlying mechanisms.