Percutaneous PD catheter insertion strategies
Most PD catheters are inserted through a surgical approach. This strategy requires the availability of a qualified surgeon, time in the operating room and general anesthesia. Therefore, surgical insertion of a PD catheter is less suitable for patients presenting a contra indication for general anesthesia such as patients with severe heart failure or multimorbidity.
PD catheters can also be inserted percutaneously using a modified Seldinger technique.
Percutaneous PD catheter insertion is performed bedside and under local anesthesia, by the nephrologist, radiologist, physician assistant, surgeon or qualified nurse.
Within Europe, including Belgium and the Netherlands, there is a lack of knowledge and experience with percutaneous insertion of PD catheters, and PD prevalence is low.
More patients could benefit from PD if the percutaneous PD catheter insertion strategy is an available option for creating a PD access within the treating nephrology center.