Ultrasound-Guided Percutaneous Peritoneal Dialysis Catheter Insertion for Urgent-Start Dialysis
Ultrasound-Guided Percutaneous Peritoneal Dialysis Catheter Insertion for Urgent-Start Dialysis: Feasibility, Technical Success, Safety, and Clinical Outcomes at Assiut University Hospital
This prospective observational study evaluates the feasibility, technical success, safety, and clinical outcomes of ultrasound-guided percutaneous peritoneal dialysis (PD) catheter insertion for urgent-start dialysis in pediatric patients with acute kidney injury (AKI).
Acute kidney injury in children frequently requires prompt renal replacement therapy. While traditional surgical placement of peritoneal dialysis catheters often requires general anesthesia and an extended waiting period before use, percutaneous insertion under real-time ultrasound guidance using a modified Seldinger technique allows for bedside placement under local anesthesia and rapid initiation of dialysis.
The study includes 50 pediatric patients (ranging from neonates up to 18 years of age) admitted to Assiut University Hospitals who require urgent renal replacement therapy and are candidates for peritoneal dialysis. Participants undergo percutaneous catheter placement guided in real time by ultrasound, followed by the initiation of an urgent-start dialysis protocol. The primary focus is to determine the technical success of the insertion procedure, evaluate catheter function and short-term catheter survival, and record procedure-related complications such as bleeding, dialysate leakage, infection, and mechanical malfunction. Secondary objectives include assessing renal recovery, patient survival to hospital discharge, and the need for conversion to alternative dialysis modalities.
Study Overview
Status
Status
Conditions
Conditions
Study Type
Study Type
Enrollment (Estimated)
Enrollment
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Sampling Method
Study Population
Pediatric patients (neonates up to 18 years of age) diagnosed with acute kidney injury according to KDIGO or pRIFLE criteria admitted to Assiut University Hospitals, Assiut, Egypt. The population includes patients requiring urgent renal replacement therapy who are candidates for peritoneal dialysis due to hemodynamic instability, lack of adequate vascular access, or clinical preference.
Description
Inclusion Criteria:
- Pediatric patients (neonates up to 18 years of age) diagnosed with acute kidney injury according to KDIGO or pRIFLE criteria.
- Clinical indication for urgent renal replacement therapy with candidacy for peritoneal dialysis (due to hemodynamic instability, lack of vascular access, or physician preference).
- Written informed consent provided by a parent or legal guardian.
Exclusion Criteria:
- Recent major abdominal surgery, abdominal wall defects, or necrotizing enterocolitis.
- Diaphragmatic hernia or ventriculoperitoneal (VP) shunt in situ.
- Uncontrolled peritonitis or intra-abdominal sepsis of surgical origin.
- Severe coagulopathy precluding safe percutaneous catheter insertion.
- Refusal of informed consent or inability to comply with protocol follow-up.
Study Plan
How is the study designed?
Design Details
- Observational Models: COHORT
- Time Perspectives: PROSPECTIVE
Number of groups / cohorts
Cohorts and Interventions
Group / CohortGroup / Cohort |
|---|
|
Pediatric Urgent-Start Peritoneal Dialysis Cohort
Pediatric patients (neonates up to 18 years) diagnosed with acute kidney injury according to KDIGO/pRIFLE criteria who require urgent renal replacement therapy and are candidates for peritoneal dialysis (due to hemodynamic instability, lack of vascular access, or clinical preference). All participants undergo percutaneous peritoneal dialysis catheter placement under real-time ultrasound guidance using a modified Seldinger technique, followed by the initiation of urgent-start peritoneal dialysis. Outcomes assessed include procedural feasibility, technical success, catheter function, short-term catheter survival, and procedure-related complications. |
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Technical Success of Catheter Placement
Time Frame: 1 hour post-procedure
|
Technical success is defined as successful percutaneous placement of the peritoneal dialysis catheter into the peritoneal cavity under real-time ultrasound guidance with immediate functional inflow and outflow, confirmed by free instillation and drainage of fluid without leakage or obstruction. |
1 hour post-procedure
|
Collaborators and Investigators
Sponsor
Sponsor
Study record dates
Study Major Dates
Study Start (Estimated)
Study Start
Primary Completion (Estimated)
Primary Completion
Study Completion (Estimated)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
Other Study ID Numbers
- US-Guided Urgent PD Catheter
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