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Improving acute peritoneal dialysis outcome with use of soft peritoneal dialysis catheter (Cook Mac-Loc Multipurpose Drainage catheter®) among infants < 1500 g in a low resource setting

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Abstract

Background

Despite its utility, uncertainty exists on the feasibility of acute peritoneal dialysis (PD) and optimal PD catheter type for very low birth weight (VLBW < 1500 g) and extremely low birth weight (ELBW < 1000 g) infants. We hereby report our experience of acute PD among these high-risk infants and compare the outcome between stylet-based rigid catheter (SRC) and Cook Mac-Loc Multipurpose Drainage catheters® (CMMDC).

Methods

Case notes of infants < 1500 g undergoing PD between 2012 and 2021 in a network of five participating neonatal units supported by a tertiary paediatric nephrology centre in Kolkata, India, were retrospectively reviewed. PD was conducted either with SRC or after 2018 with CMMDC. Outcome parameters included complications, survival during PD, and survival to discharge.

Results

24 infants (VLBW: n = 13 and ELBW: n = 11) underwent PD at median age 4.5 days (IQR 3–6) with either CMMDC (n = 14) or SRC (n = 10). Significant improvement in biochemical parameters and fluid removal was seen in both ELBW and VLBW infants. CMMDC was associated with significantly fewer PD-related complications 7/14 (50%) vs. 9/10 (90%) (p = 0.04) and higher survival during PD 13/14 (93%) vs. 5/10 (50%) (p = 0.02), without significant difference in survival to hospital discharge 8/14 (57%) vs. 3/10 (30%) (p = 0.25). CMMDC also enabled longer duration of PD, higher ultrafiltration, and better control of acidosis. Consumable cost was higher for CMMDC (USD$60) than SRC (USD$14).

Conclusions

In a low resource setting, CMMDC had lower PD complications and superior short-term survival among ELBW/VLBW infants.

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Authors and Affiliations

  1. Institute of Child Health, Kolkata, India

    Rajiv Sinha, Rana Saha, Deblina Dasgupta & Niladri Bose

  2. Apollo Glenagles Hospital, Kolkata, India

    Rajiv Sinha

  3. AMRI Hospital, Mukundapur, Kolkata, India

    Rana Saha

  4. Bhagirathi Neotia Women and Child Care Hospital, Kolkata, India

    Rana Saha, Ashok Modi & Bikramjit Das

  5. Columbia Asia Hospital, Kolkata, India

    Shamik Ghosh

  6. Red Cross War Memorial Children’s Hospital, Cape Town, South Africa

    Mignon McCulloch

  7. Great North Children’s Hospital, Newcastle upon Tyne, UK

    Yincent Tse

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All the authors have approved the submitted manuscript. All of us have participated sufficiently in the work to take public responsibility for the contents. All the authors have made substantial contributions to the intellectual content of the paper and fulfil at least 1 condition for each of the 4 categories of contributions: Category 1 (conception and design, acquisition of data, analysis, and interpretation of data), Category 2 (drafting of the manuscript, critical revision of the manuscript for important intellectual content), Category 3 (final approval of the version to be published), and Category 4 (Agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved).

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Correspondence to Rajiv Sinha.

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Sinha, R., Saha, R., Dasgupta, D. et al. Improving acute peritoneal dialysis outcome with use of soft peritoneal dialysis catheter (Cook Mac-Loc Multipurpose Drainage catheter®) among infants < 1500 g in a low resource setting. Pediatr Nephrol 38, 1241–1248 (2023). https://doi.org/10.1007/s00467-022-05700-4

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