Peritoneal Dialysis Catheter Utilization and Related Complications at an Urban Safety-Net Hospital
Noreen Siddiqi1, Luise I. Pernar2
1Boston University School of Medicine, Boston, MA; 2Boston University School of Medicine, Boston Medical Center, Boston, MA
Background: Racial minority groups are over-represented among patients requiring dialysis. This study aimed to understand the utilization of and complications associated with PD at an urban safety-net hospital serving a large minority population.
Methods: Charts of patients undergoing laparoscopic PD catheter placement between 01/2012 and 12/2021 were retrospectively reviewed to extract patient demographics, operation details, and outcomes. Early (within 30 days of surgery) and late complications were recorded. Complications were classified as infectious, surgical/mechanical, and non-surgical.
Results: 202 PD catheters were placed. 106 (52%) patients were men, 119 (59%) Black, and 39 (19%) White. 109 patients (54%) started PD as first modality. Short- and long-term complications, revision, and removal rates were highest among Black patients, in proportion to the rate at which PD catheters were placed. Black patients accounted for 93% of revisions due to drainage problems. Black patients were most likely to require catheter removal due to infection whilst White patients were most likely to undergo catheter removal because they went on to renal transplantation.
Conclusion: At an urban safety-net hospital, Black patients accounted for the majority of patients receiving a PD catheter as well as experiencing PD catheter-associated complications and need for additional surgeries. There are, significant racial disparities in frequencies of surgical intervention for drainage-related problems and removal of catheter for transition to renal transplantation. Future analyses should seek to elucidate drivers of these racial disparities.
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