Risk factors for early peritoneal dialysis catheter failure in children.
BACKGROUND
There is uncertainty regarding the optimal approach for surgical placement of peritoneal dialysis (PD) catheters in children. Operative technique, catheter selection, and patient variables (eg, age or prior surgical history) may influence catheter lifespan.


METHODS
A retrospective review of all PD catheters placed at a tertiary children's medical center during a 6-year period was performed. Our primary outcome was catheter function 2 months after placement. Data were analyzed using Student 2-tailed t test or chi(2) analysis.


RESULTS
There were 121 PD catheters placed in 81 patients. The median primary functional catheter lifetime was 109 days. Primary PD catheter failure (within 2 months) occurred in 36 catheters (30%). Patients with primary catheter failure (8 +/- 7 years) were younger than patients with a functioning catheter at 2 months (12 +/- 5 years; P = .002). Catheters placed without simultaneous omentectomy were more likely to fail (P = .042). Catheter failure rate was not significantly different based upon operative technique or catheter type.


CONCLUSIONS
Omentectomy at the time of catheter placement decreased the risk of early catheter failure. In contrast, type of catheter or laparoscopic placement did not influence the likelihood of early catheter failure.
Cribbs
Randolph K
RK
Division of Pediatric Surgery, Department of Surgery, Emory University, Atlanta, GA 30322, USA.
Greenbaum
Larry A
LA
Heiss
Kurt F
KF
D000293:Adolescent; D002408:Catheters, Indwelling; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D020878:Device Removal; D004868:Equipment Failure; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D010535:Laparoscopy / Q000009:adverse effects / Q000379:methods*; D008297:Male; D010530:Peritoneal Dialysis / Q000009:adverse effects / Q000295:instrumentation* / Q000379:methods; D011336:Probability; D051437:Renal Insufficiency / Q000628:therapy; D012086:Reoperation; D012189:Retrospective Studies; D018570:Risk Assessment; D013997:Time Factors; D055815:Young Adult