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Official publication of the Indian Society of Nephrology
 
ORIGINAL ARTICLE
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Peritoneal dialysis catheter insertion by nephrologist using minilaparotomy: Do survival and complications vary in obese?


1 Department of Nephrology, Military Hospital, Jalandhar, Punjab, India
2 Department of Nephrology, Command Hospital, Kolkata, West Bengal, India

Correspondence Address:
Pavitra Manu Dogra,
Department of Nephrology, Army Hospital (R&R), New Delhi - 110 010
India
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/ijn.IJN_341_20

Introduction: Peritoneal dialysis catheter (PDC) placement for chronic kidney disease (CKD) amongst overweight and obese patients is difficult owing to deeper operating field. Literature being discordant on survival and complications in this patient subset, we attempted to analyse this research question in Indian population. Materials and Methods: We retrospectively analysed PDC inserted by nephrologist using surgical minilaparotomy for survivals and complications amongst 'overweight and obese' cohort ('O') at two tertiary care government hospitals in India, and compared results with normo-weight cohort ('N'), with 12−36 months follow-up. Results: 245 PDCs were inserted by surgical minilaparotomy and 'N' to 'O' ratio was 169:76. 'O' group were more rural residing (P = 0.003) and post-abdominal surgery (P = 0.008) patients. The 1, 2, and 3-year death censored catheter survival rate was 98.6%, 95.8%, and 88.2% respectively in 'O' group, and 97.6%, 94.5% and 91.8% in 'N' group respectively (P = 0.52). Patient survival (P = 0.63), mechanical complications (P = 0.09) and infective complications (P = 0.93) were comparable despite technically challenging surgery in 'O' group. Refractory peritonitis related PDC removal was comparable (P = 0.54). Prior haemodialysis or catheter related blood stream infections or diabetes were non-contributory to results. Conclusions: Catheter survival and patient survival amongst obese and overweight CAPD patients was non-inferior to normal weight patients. Mechanical, and infective complications were comparable despite technically challenging abdominal terrain in 'O' group. The overall CAPD performance was good amongst obese and overweight.


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    -  Dogra PM
    -  Nair RK
    -  Katyal A
    -  Shanmugraj G
    -  Hooda AK
    -  Jairam A
    -  Mendonca S
    -  Chauhan PS
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Indian Journal of Nephrology
Published by Wolters Kluwer - Medknow
Online since 20th Sept '07