Series 3


Series 1

Peritoneal Dialysis Catheter Insertion is an Essential Medical Service for Kidney Failure Patients in COVID-19 Pandemic


Series 2

A Safe Technique With Outcomes Shown to be Equivalent to—or Even Better Than—Surgically Placed Peritoneal Dialysis Catheters


Series 3

Nephrologist-Inserted Catheter Demonstrated a Higher Peritoneal Dialysis Utilization Rate and a Shorter Rate of Initiation with Lesser Complications


Series 4

Minimally Invasive Approach Technique and Reduced Dependence on Resources in Operating Theaters

A nephrologist-inserted catheter is an antecedent to a higher PD utilization rate and shorter initiation rate1

A population-based retrospective cohort study demonstrated that the nephrologist-inserted catheter showed:

  • Greater PD utilization (aHR 1.59, 95% CI 1.29-1.95).1
  • Shorter initiation rate (PD: 27 days) than other insertion operators and insertion methods.1




Nephrology catheter insertion led to a higher likelihood of PD utilization. This may be related to insertion timing, technique, or greater commitment from nephrologists to the success of PD.1

Improved catheter survival rate with nephrologist - led percutaneous catheter insertion2,3


  • A retrospective study revealed that nephrologist-led percutaneous catheter placement improved catheter survival and provided a safe and reliable access for PD.3
  • One-year and two-year technical survivals were 90% and 82% in group P (percutaneous) and 73% and 60% in group S (surgical) (p=0.0032), respectively.

PD: Peritoneal Dialysis

Nephrologist-Ied percutaneous insertion has similar risks of infectious and non-infectious complications as surgical insertion4

The Brazilian large national multicentric cohort study (Brazilian Peritoneal Dialysis Multicentric Study, BRAZPD) with 736 patients demonstrated that early mechanical and infectious complications following catheter insertion showed no difference in rates, regardless of operator.4



  • Hazard ratios for mechanical, infectious, and overall complications were adjusted for age, body mass index, catheter type, diabetes, and number of procedures performed per center.

CI: Confidence Interval; HR: Hazard Ratio

A greater commitment from nephrologists improves patient’s confidence and utility of the therapy5

PD penetration rate when compared with HD in Hospital Serdang after starting integrated care approach to CAPD5



  • Hospital Serdang achieved a PD penetration rate 4.5 times the national average with nephrologist involvement.
  • Attributed to direct involvement of the nephrologists:
    • Improves patients’ confidence
    • Allows PD catheters to be placed in a timely manner

HD: Hemodialysis; PD: Peritoneal dialysis; CAPD: Continuous Ambulatory Peritoneal Dialysis

A multicenter study analyzed the impact of PD catheter insertion by nephrologists on the PD population at three centers (an academic medical center; a private setting center; and an academic medical center).6

Study results revealed that PD catheter insertion program managed and operated by nephrologists can have a positive impact on PD utilization.6

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Interventional nephrologist-led catheter insertion provides more advantages over surgeon-led catheter insertions.

Interventional nephrologist

Interventional nephrologist

  • Greater PD utilization with short time needed for initiation
  • Longer catheter survival
  • Minimally invasive and requires local anesthesia
  • Lesser rates of catheter-related infections and exit-site leak
  • Continuity of care


  • Risks of delays
  • Shorter catheter survival
  • More dissection and requires general anesthesia
  • Higher incidence of complications
  • Shorter continuity of care

Adapted from: Asif et al.7,8, Ash9–12, and Gadallah et al.13–14