Joseph V. Pezo-Medina, Nephrology Service, Department of Internal Medicine, Tarapoto’s Hospital-MINSA, Tarapoto, Peru; Faculty of Human Medicine, National University of San Martín, Tarapoto, Peru;
Isabel Saravia, Department of Medical, Vantive, Bogotá D.C., Colombia
Susan Martínez, Department of Epidemiology, EpiThink Health Consulting, Bogotá D.C., Colombia
Objective: The objective of the study was to compare outcomes of Tenckhoff catheter insertion performed percutaneously by nephrologists versus surgically by general surgeons in a hospital in Peru. Materials and methods: Retrospective cohort study included adult with end-stage kidney disease who underwent peritoneal dialysis catheter insertion (2020-2024). A total of 123 catheter insertion procedures were analyzed (77 surgical and 46 percutaneous). The outcome was catheter survival, defined as time from insertion to catheter failure or transfer to hemodialysis for technique failure; patients were censored at last follow-up. Kaplan–Meier methods and Cox regression were used. Results: Twenty-six catheter failure events (21.1%). Median catheter survival was not reached in either group. One-year catheter survival was 0.789 (95% confidence interval [CI], 0.696-0.894) in the surgical group and 0.860 (95% CI, 0.751-0.986) in the percutaneous group; the log-rank test showed no evidence of a between-group difference (p = 0.828). In unadjusted Cox analysis, the hazard ratio (HR) for catheter failure comparing percutaneous versus surgical placement was 0.91 (95% CI, 0.37-2.21; p = 0.8). After adjustment for age, sex, diabetes, and prior abdominal surgery, the association remained similar (adjusted HR [aHR], 0.81; 95% CI, 0.28-2.31; p = 0.7). Male sex was associated with higher catheter failure risk (aHR, 3.58; 95% CI, 1.56-8.23; p = 0.003). Conclusion: We found no evidence of a difference in catheter survival between percutaneous placement by nephrologists and open surgical placement by surgeons within the observed follow-up. Baseline case-mix differences and fewer percutaneous procedures under observation at later time points limit longer-term comparisons.
Keywords: Peritoneal dialysis. Catheter survival. Tenckhoff catheter. Nephrology procedures. Surgical technique. Resource-limited settings.
