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Meta-Analysis
. 2022 Nov;407(7):2651-2662.
doi: 10.1007/s00423-022-02637-y. Epub 2022 Aug 9.

Peritoneal dialysis catheter removal at the time or after kidney transplantation: a systematic review and meta-analysis

Michał Zawistowski  1   2 , Joanna Nowaczyk  1 , Piotr Domagała  3
Affiliations
Meta-Analysis

Peritoneal dialysis catheter removal at the time or after kidney transplantation: a systematic review and meta-analysis

Michał Zawistowski et al. Langenbecks Arch Surg. 2022 Nov.

Abstract

Purpose: An increasing number of patients treated with peritoneal dialysis eventually undergo kidney transplantation. Owing to opposing reports, we aimed to find evidence about the best time for peritoneal dialysis catheter removal in transplant patients.

Methods: We conducted a systematic review and random effects meta-analysis of non-randomized studies of intervention comparing patients with peritoneal dialysis catheters left in place or removed during kidney transplantation in regard to the need for dialysis and occurrence of catheter-related complications. We searched (last update on 8 December 2021) PubMed, Embase, Scopus, and Web of Science for eligible studies. ROBINS-I tool and funnel plot asymmetry analysis were used to assess the quality of included articles.

Results: Eight observational studies were evaluated. Five of them, which involved 338 patients, were included in a meta-analysis. All were at moderate to serious risk of bias. The odds of needing dialysis are more than twice as high for patients with peritoneal dialysis catheters left in situ (pooled odds ratio, 2.21; 95% confidence interval [CI], 1.03 to 4.73; I2 = 0%). No statistically significant difference was noted when adult and pediatric subgroups were compared (Q = 0.13, P = .720). More individuals with catheters left in place required dialysis (pooled prevalence, 20.9%; 95% CI, 13.6 to 30.7%; I2 = 59% vs. 12.4%; 95% CI, 5.6 to 25.2%; I2 = 0%) and experienced catheter-related infections.

Conclusion: Available evidence is scarce. Unless new data from a randomized controlled trial are available, the dilemma of peritoneal dialysis catheter removal cannot be solved.

Trial registration: PROSPERO Protocol ID: CRD42020207707.

Keywords: Catheter removal; Delayed graft function; Kidney transplantation; Peritoneal dialysis catheter.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
PRISMA 2020 flow chart of the study screening and selection for the systematic review
Fig. 2
Fig. 2
“Traffic light” (a) and weighted bar (b) risk of bias charts for studies included in the systematic review
Fig. 3
Fig. 3
Funnel plot for the assessment of publication bias
Fig. 4
Fig. 4
Forest plot with the subgroup analysis. Non-adjusted odds ratios for the need of dialysis in patients with PD catheter left in situ (the experimental group) and those after its removal at the time of kidney transplantation (the control group). PDC, peritoneal dialysis catheter
Fig. 5
Fig. 5
Forest plots showing the pooled prevalence of needing dialysis by patients in the experimental (a) and control (b) groups
Fig. 6
Fig. 6
Forest plots showing the pooled prevalence of peritonitis (a) and catheter-related infections (b) in patients with peritoneal dialysis catheters left in place after kidney transplantation
See this image and copyright information in PMC

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References

    1. Manera KE, Johnson DW, Craig JC, et al. Establishing a core outcome set for peritoneal dialysis: report of the SONG-PD (standardized outcomes in nephrology–peritoneal dialysis) consensus workshop. Am J Kidney Dis. 2020;75:404–412. doi: 10.1053/j.ajkd.2019.09.017. - DOI - PubMed
    1. Chan C, Combes G, Davies S, et al. Transition between different renal replacement modalities: gaps in knowledge and care—the integrated research initiative. Perit Dial Int. 2019;39:4–12. doi: 10.3747/pdi.2017.00242. - DOI - PMC - PubMed
    1. McGregor T. The PD catheter dilemma. Can Urol Assoc J J Assoc Urol Can. 2012;6:379–379. doi: 10.5489/cuaj.12270. - DOI - PMC - PubMed
    1. Melek E, Baskın E, Gülleroğlu KS, et al. Timing for removal of peritoneal dialysis catheters in pediatric renal transplant patients. Exp Clin Transplant Off J Middle East Soc Organ Transplant. 2016;14:74–77. doi: 10.6002/ect.tondtdtd2016.P24. - DOI - PubMed
    1. Peluso G, Incollingo P, Carlomagno N, et al. Our timing to remove peritoneal catheter dialysis after kidney transplant. Transplant Proc. 2019;51:160–163. doi: 10.1016/j.transproceed.2018.04.075. - DOI - PubMed

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