Omentectomy reduces the need for peritoneal dialysis catheter revision in children: a study from the Pediatric Nephrology Research Consortium.

Autor:	Schuh MP; Department of Pediatrics, Division of Nephrology and Hypertension, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, OH, USA., Nehus E; Department of Pediatrics, Division of Nephrology and Hypertension, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, OH, USA., Liu C; Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA., Ehlayel A; Division of Nephrology, Children's Hospital of Philadelphia, Philadelphia, PA, USA., Clark S; Division of Nephrology, Children's Hospital of Philadelphia, Philadelphia, PA, USA., Chishti A; Division of Nephrology, University of Kentucky, Lexington, KY, USA., Edwards-Richards AD; Division of Nephrology, Wake Forest Baptist Health, Winston-Salem, NC, USA., Erkan E; Department of Pediatrics, Division of Nephrology and Hypertension, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, OH, USA., Jernigan S; Division of Nephrology, Children's Healthcare of Atlanta, Atlanta, GA, USA., Kamel M; Division of Nephrology, Children's Healthcare of Atlanta, Atlanta, GA, USA., Luckritz K; Division of Nephrology, CS Mott Children's Hospital, Ann Arbor, MI, USA., Magella B; Department of Pediatrics, Division of Nephrology and Hypertension, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, OH, USA., Mansuri A; Division of Nephrology, Medical College of Georgia, Children's Hospital of Georgia, Augusta University, Augusta, GA, USA., Wilson AC; Department of Pediatrics, Division of Nephrology and Hypertension, Indiana University School of Medicine, Indianapolis, IN, USA.; Riley Hospital for Children at IU Health, Indianapolis, IN, USA., Claes DJ; Department of Pediatrics, Division of Nephrology and Hypertension, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, OH, USA. Donna.Claes@cchmc.org.
Jazyk:	angličtina
Zdroj:	Pediatric nephrology (Berlin, Germany) [Pediatr Nephrol] 2021 Dec; Vol. 36 (12), pp. 3953-3959. Date of Electronic Publication: 2021 Jun 14.
DOI:	10.1007/s00467-021-05150-4
Abstrakt:	Background: There are no multi-center studies examining omentectomy and peritoneal dialysis (PD) catheter revision in the pediatric dialysis population. Methods: We performed a retrospective study at eight centers within the Pediatric Nephrology Research Consortium (PNRC). Data review included all incident tunneled PD catheters placed between 1/1/2011 and 12/31/2016 in pediatric stage 5 chronic kidney disease (CKD 5) patients. The primary outcome was the need for catheter revision and/or replacement. Multivariable logistic regression was performed to evaluate predictors for catheter revision/replacement. Results: Data from 184 children (62.5% male; median age 7.4 years) were analyzed. Omentectomy was completed in 63.6% (n = 117). Revision/replacement occurred in 34.2% (n = 63); median time to revision/replacement was 38.5 days after insertion. PD catheter revision/replacement catheter occurred in 23.9% who underwent omentectomy versus 52.2% without omentectomy (p = 0.0005). Children ≥ 6 years at the time of catheter insertion experienced fewer revisions/replacements (18.2% age ≥ 6 vs. 56.5% age < 6 years, p <0.001). After adjusting for covariates, omentectomy reduced the need for revision by 63%; revision was 3.66 times more likely in those < 6 years of age. Conclusions: This multi-center study demonstrates that omentectomy at the time of PD catheter insertion in pediatric patients is strongly associated with reduced likelihood of PD catheter revision. Omentectomy should be considered at the time of PD catheter insertion, especially in young children who are at high risk for PD catheter malfunction. A higher resolution version of the Graphical abstract is available as Supplementary information. (© 2021. IPNA.)
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu Plný text ve formátu PDF