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

Meredith P. Schuh, Edward Nehus, Chunyan Liu, Abdulla Ehlayel, Stephanie Clark, Aftab Chishti, Alcia Delaney Edwards-Richards, Elif Erkan, Stephanie Jernigan, Margret Kamel, Kera Luckritz, Bliss Magella, Asif Mansuri, Amy C. Wilson, Donna J. Claes

Research output: Contribution to journalArticlepeer-review

3 Scopus citations

Abstract

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. Graphical abstract: [Figure not available: see fulltext.].

Original languageEnglish (US)
Pages (from-to)3953-3959
Number of pages7
JournalPediatric Nephrology
Volume36
Issue number12
DOIs
StatePublished - Dec 2020

Keywords

  • Catheter malfunction
  • Children
  • Omentectomy
  • Pediatric nephrology
  • Peritoneal dialysis
  • Stage 5 chronic kidney disease

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Nephrology

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