Comparison of Complications of Conventional Peritoneal Catheters with Nephrostomy Catheters in Children with Acute Kidney Failure Undergoing Acute Peritoneal Dialysis

Abstract

Background: Acute kidney injury (AKI) is a serious problem among hospitalized children and is associated with adverse outcomes. Peritoneal dialysis is the preferred modality for treating AKI in children. Nephrostomy catheters may serve as an alternative to rigid catheters, given the latter’s suboptimal design and associated complications. Objectives: This study aimed to compare catheter-related complications between nephrostomy and rigid catheters in children with AKI who required acute peritoneal dialysis. Methods: In this randomized clinical trial, children aged 0 - 12 years with AKI requiring urgent peritoneal dialysis were randomly assigned to receive either a rigid catheter (control group) or a nephrostomy catheter (intervention group). Demographic and clinical data were collected, and outcomes included catheter-related complications. Results: A total of 50 children were enrolled. Catheter leakage occurred in 28% of patients in the rigid catheter group and 20% in the nephrostomy group (odds ratio [OR] = 0.64; 95% confidence interval [CI], 0.17 - 2.38; P = 0.50). The mean duration of catheter use differed significantly between the groups, with a mean difference of 2.24 days (95% CI, 0.18 - 4.29; P = 0.02). No significant differences were observed between the 2 groups in peritonitis, exit-site infection, the need for chronic dialysis, or mortality (all P > 0.05). Conclusions: Both catheter types are feasible for acute peritoneal dialysis in children with AKI. However, because nephrostomy catheters had a significantly longer catheter survival duration, their use may offer a relative advantage in specific conditions. Multicenter studies with larger sample sizes are recommended to confirm these findings.