Laparoscopic versus Open Surgery Catheter Placement in Peritoneal Dialysis Patients: A Meta-Analysis of Outcomes.

Introduction: The peritoneal dialysis catheter (PDC) can be placed either through the laparoscopic technique, percutaneous technique, or surgical procedures. The utilization of these PDC placement procedures is based on the successful placement and reduced risk of development of complications. The main objective of this study was to compare the complications associated with the laparoscopic technique to those linked to open surgery during PDC placement. Methods: The literature for this review was obtained from the PubMed and Google Scholar databases. The literature search was limited to studies published in the period between 1998 and 2019. The meta-analysis was done using Stata Version 12. Results: The results showed a significant difference in catheter malfunction rates between the laparoscopic and open surgery groups (relative risk [RR] = 0.58; 95% confidence interval [CI]: 0.42-0.8, P = 0.031). There was no statistically significant difference in dialysate leakage (RR = 0.77; 95% CI: 0.51-1.17, P = 0.116), peritonitis (RR = 0.8; 95% CI: 0.6-1.06, P = 0.349), and exit-site infection (RR = 0.84; 95% CI: 0.65-1.09, P = 0.834) between two groups. Conclusion: In conclusion, the laparoscopic PDC placement procedure was superior to open surgery with regard to catheter malfunction.

Establishment of a time-resolved immunoassay for acute kidney injury based on the detection of Kim-1.

AIM: To establish a highly sensitive time-resolved fluorescence immunoassay (TRFIA) of kidney injury molecule-1 (Kim-1) and evaluate its clinical value in acute kidney injury (AKI). METHODS: The Kim-1-TRFIA was established by the double-antibody sandwich method, and the method was evaluated. The established Kim-1-TRFIA was used to detect the concentration of Kim-1 in the serum of healthy controls and patients with AKI. RESULTS: The optimal coating antibody concentration and optimal Eu3+ -labeled antibody dilution ratio for Kim-1-TRFIA are 1 µg/ml and 1:140, respectively. The linear range is 42.71-4666.69 pg/ml. The intra- and inter-assay coefficients of variation are <10%. The specificity of our Kim-1-TRFIA is acceptable. The recovery is between 95.14% and 102.84%. The concentration of Kim-1 in the serum of patients with AKI is 126.50 ± 67.99 pg/ml, which is significantly higher than that in the serum of healthy controls (49.72 ± 16.40 pg/ml, p < 0.001). Staging patients with AKI by glomerular filtration rate shows that the serum concentration of Kim-1 increases significantly with increasing disease severity (p < 0.05). CONCLUSION: A highly sensitive Kim-1-TRFIA was established. With this immunoassay, a good differential diagnosis can be made, and healthy people and AKI patients can be differentiated by detecting the concentration of Kim-1 in the serum. Moreover, the severity of AKI patients can be determined.

Laparoscopic versus Open-surgery Catheter Placement in Peritoneal Dialysis Patients: A Meta-analysis of Outcomes.

The peritoneal dialysis catheter (PDC) can be placed either through the laparoscopic technique, percutaneous technique or surgical procedures. The utilization of these PDC placement procedures is based on successful placement and reduced risk of development of complications. The main objective of this study was to compare the complications associated with laparoscopic vs. open-surgery PDC placement procedure. Literature for this review was obtained from PubMed and Google Scholar databases. The literature search was limited to studies published in the period between 1998 and 2019. The meta-analysis was done using Stata Version 12. The results showed significant difference in catheter malfunction between the laparoscopic and open-surgery group (relative risk [RR] =0.58; 95% CI: 0.42-0.8; P = 0.031). Furthermore, there was no significant statistical difference in dialysate leakage (RR = 0.77; 95% CI: 0.51-1.17, P = 0.116) peritonitis (RR = 0.8; 95% CI: 0.6-1.06, P = 0.349) and exit-site infection (RR = 0.84; 95% CI: 0.65-1.09, P = 0.834) between the laparoscopic and open-surgery PDC placement groups. In conclusion, the laparoscopic PDC placement procedure was superior to open surgery in regards to catheter malfunction. Additionally, the choice of treatment procedure should put in consideration factors such as cost and comfortability of the patient.