Early outcomes of peritoneal dialysis in a middle-income country: A retrospective cohort study of a large dialysis network in Colombia.

BACKGROUND: The first year of dialysis is critical given the significant risk for complications following dialysis initiation. We analysed complications during the first year among incident peritoneal dialysis (PD) patients. METHODS: This retrospective cohort study comprised adult kidney failure patients starting PD in Baxter Renal Care Services in Colombia, receiving their first PD catheter between 1 January 2017 and 31 December 2020 and were followed up for up to 1 year. We analysed incidence, causes and factors associated with complications using logistic regression and transfer to haemodialysis (HD) using the Fine-Gray regression model. RESULTS: Among 4743 patients receiving their first PD catheter: 4628 (97.6%) of catheter implantations were successful; 377 (7.9%) patients experienced early complications. The incidence rate of complications during the year was 0.51 events per patient-year (95% CI: 0.48-0.54). Age, obesity and urgent start were associated with higher probability of complications after catheter implantation. The cumulative incidence of transfer to HD within 1 year of PD initiation was 10.1% [95% CI: 9.2-11.1%]. The hazard function for transfer to HD showed an accelerating pattern during the first month followed by progressive decrease during the first year. CONCLUSIONS: In this large population of incident PD patients, there is a high primary catheter placement success rate. Urgent start, age ≥65 years, obesity, centre size ≥150 PD patients and diabetes were risk factors associated with early complications. The follow-up of the cohort from day 1 of PD treatment showed that the risk for transfer to HD was higher during the first month.

Método de fijación del tubo traqueal en pacientes críticamente enfermos en una unidad de terapia intensiva / Method of fixation of the tracheal pipe in critically sick patients in a unit of intensive therapy

Introducción: Los pacientes en terapia intensiva con ventilación mecánica, por ende con tubo traqueal necesitan mantenerlos en buena posición para evitar complicaciones, por eso nace la necesidad de implementar métodos adecuados para su fijación. Objetivo: Evaluar la eficacia del método de fijación del tubo traqueal en pacientes críticamente enfermos en una unidad de terapia intensiva. Método: Descriptivo, comparativo, prospectivo; conformado por 55 pacientes en el Servicio de Terapia Intensiva del Hospital de Niños "Dr. José Manuel de los Ríos", Caracas, Venezuela, durante el tercer trimestre del año 2005. Criterio de inclusión fue todo paciente con tubo traqueal. Se registro en tess con 5 indicadores y 20 subindicadores. Resultado: El método de fijación más usado fue el de tres bandas (61,8 por ciento), y las complicaciones predominantes fueron selectividad bronquial (49,1 por ciento), intubación, reintubación y cambio de adhesivo (38,2 por ciento), siendo la higiene broncopulmonar estadísticamente significativa (p = < 0,002), el método de fijación utilizado resultó independiente de las complicaciones. Conclusiones: Se evidenció que es necesario implementar métodos más eficaces de fijación del tubo traqueal.