title: Factors associated with early peritoneal dialysis catheter replacement in Veracruz, Mexico.
abstract: BACKGROUND
  Catheter-related complications in patients on peritoneal dialysis lead to decreased effectiveness and discontinuation of the technique, conversion to haemodialysis, hospitalisation, and surgical interventions to replace the catheter.
  
  
  OBJECTIVE
  Determine risk factors for early catheter dysfunction that result in the need for replacement.
  
  
  METHODS
  We analysed 235 catheters placed by open surgery using an infra-umbilical midline incision. Possible risk factors included the following: age, sex, body mass index, body surface area, diabetes, polycystic kidney disease, previous surgery, time of surgical procedure, omentectomy, omentopexy, wound infection and postoperative incisional hernia.
  
  
  RESULTS
  During the first year, 47 patients (20%) required a catheter replacement due to poor function. The most common complications were catheter migration and peritonitis (4.3% in both cases), followed by obstruction from omental wrapping (3.7%). Univariate analysis showed that patients with catheter dysfunction or requiring catheter replacement were younger, with a lower body mass index and body surface area (P<.05). There was a significant association of wound infection and post-operative incisional hernia with catheter replacement. Omentectomy was associated with a low incidence rate of catheter dysfunction/replacement in the univariate and logistical regression analyses (odds ratio: 0.275; 95% confidence interval: 0.101-0.751; P<.012).
  
  
  CONCLUSIONS
  Our catheter placement technique offers a low complication rate and good results in the first year after surgery. Except for omentectomy, we did not discover any risk factors for catheter replacement in our study population. Omentectomy had a protective effect in terms of catheter replacement.
authors.affiliation: Hospital Regional de Alta Especialidad de Veracruz, Veracruz, Mexico. gmtzmier@hotmail.com
authors.forename: Gustavo
authors.initials: G
authors.lastname: Martínez-Mier
authors.forename: Marisol
authors.initials: M
authors.lastname: Luna-Castillo
authors.forename: Jorge J
authors.initials: JJ
authors.lastname: Ortiz-Enríquez
authors.forename: Sandro F
authors.initials: SF
authors.lastname: Avila-Pardo
authors.forename: Vicente
authors.initials: V
authors.lastname: Fernández
authors.forename: Marco T
authors.initials: MT
authors.lastname: Méndez-López
authors.forename: Luis
authors.initials: L
authors.lastname: Budar-Fernández
authors.forename: Felipe
authors.initials: F
authors.lastname: González-Velázquez
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D055499:Catheter-Related Infections / Q000453:epidemiology / Q000209:etiology; D057785:Catheters / Q000009:adverse effects*; D002408:Catheters, Indwelling; D020878:Device Removal; D004868:Equipment Failure; D005260:Female; D005548:Foreign-Body Migration / Q000453:epidemiology / Q000209:etiology; D046449:Hernia, Abdominal / Q000453:epidemiology / Q000209:etiology; D006801:Humans; D008297:Male; D008800:Mexico / Q000453:epidemiology; D008875:Middle Aged; D009852:Omentum / Q000601:surgery; D010530:Peritoneal Dialysis / Q000295:instrumentation; D010531:Peritoneal Dialysis, Continuous Ambulatory / Q000295:instrumentation*; D010538:Peritonitis / Q000453:epidemiology / Q000209:etiology; D012189:Retrospective Studies; D012307:Risk Factors; D014946:Wound Infection / Q000453:epidemiology / Q000209:etiology; D055815:Young Adult