title: Similar outcomes of catheters implanted by nephrologists and surgeons: analysis of the Brazilian peritoneal dialysis multicentric study.
abstract: A good catheter implantation technique is important to allow for effective peritoneal access function and long-term technique survival. Studies regarding results obtained by nephrologists in comparison with surgeons have been limited to small single-center experiences. Thus, the objective of this study was to explore the impact of the peritoneal dialysis (PD) catheter insertion operator on early catheter complications and on technique survival in a large national multicentric cohort study (Brazilian Peritoneal Dialysis Multicentric Study, BRAZPD). Adult incident patients recruited in the BRAZPD from December 2004 to October 2007 having undergone first PD catheter implantation were included in the analysis. Mechanical and infectious early complication rates were defined as time to the first event occurring up to 3 months after catheter insertion and adjusted for comorbidities. Valid data of 736 patients (mean age of 59 ± 16 years old, 52% women, 61% white) were analyzed. Mechanical (HR 0.99 [CI 0.56-1.76]; p = 0.98) and infectious (HR 0.63 [CI 0.32-1.23]; p = 0.17) early complication rates were similar between groups. Long-term catheter survival was also similar between groups. Early complications rates and catheter survival were similar between groups defined by operator profile (nephrologist or surgeon), supporting the role of interventional nephrology in the placement of PD catheters.
authors.affiliation: Pontifícia Universidade Católica do Paraná, Curitiba, Brazil.
authors.forename: Thyago P
authors.initials: TP
authors.lastname: de Moraes
authors.forename: Rodrigo P
authors.initials: RP
authors.lastname: Campos
authors.forename: Márcia Tokunaga
authors.initials: MT
authors.lastname: de Alcântara
authors.forename: Domingos
authors.initials: D
authors.lastname: Chula
authors.forename: Marcos A
authors.initials: MA
authors.lastname: Vieira
authors.forename: Miguel C
authors.initials: MC
authors.lastname: Riella
authors.forename: Márcia
authors.initials: M
authors.lastname: Olandowski
authors.forename: José Carolino
authors.initials: JC
authors.lastname: Divino-Filho
authors.forename: Roberto
authors.initials: R
authors.lastname: Pecoits-Filho
mesh_terms: D000368:Aged; D001938:Brazil / Q000453:epidemiology; D002404:Catheterization / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010530:Peritoneal Dialysis / Q000295:instrumentation*; D011183:Postoperative Complications / Q000453:epidemiology; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D016016:Proportional Hazards Models; D012307:Risk Factors; D016019:Survival Analysis; D016896:Treatment Outcome