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.
Studieoversikt
Status
Studietype
Registrering (Antatt)
Deltakelseskriterier
Kvalifikasjonskriterier
Alder som er kvalifisert for studier
Tar imot friske frivillige
Kjønn som er kvalifisert for studier
Prøvetakingsmetode
Studiepopulasjon
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.
Beskrivelse
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.
Studieplan
Hvordan er studiet utformet?
Designdetaljer
- Observasjonsmodeller: COHORT
- Tidsperspektiver: PROSPECTIVE
Kohorter og intervensjoner
Gruppe / Kohort |
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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. |
Hva måler studien?
Primære resultatmål
Resultatmål |
Tiltaksbeskrivelse |
Tidsramme |
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Technical Success of Catheter Placement
Tidsramme: 1 hour post-procedure
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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
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Samarbeidspartnere og etterforskere
Sponsor
Studierekorddatoer
Studer hoveddatoer
Studiestart (Antatt)
Primær fullføring (Antatt)
Studiet fullført (Antatt)
Datoer for studieregistrering
Først innsendt
Først innsendt som oppfylte QC-kriteriene
Først lagt ut (Faktiske)
Oppdateringer av studieposter
Sist oppdatering lagt ut (Faktiske)
Siste oppdatering sendt inn som oppfylte QC-kriteriene
Sist bekreftet
Mer informasjon
Begreper knyttet til denne studien
Nøkkelord
Ytterligere relevante MeSH-vilkår
Andre studie-ID-numre
- US-Guided Urgent PD Catheter
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