Peritoneal dialysis therapy discontinuation due to noninfectious complications: Insights from a retrospective study in end-stage renal disease patients from Saudi Arabia

ABSTRACT

Background:
Noninfectious complications (NCs) disrupt the continuity of peritoneal dialysis (PD) and may result in catheter loss.


Aims and Objectives:
This retrospective study evaluated the incidence, risk factors, and impact of NCs on PD catheter outcomes in patients aged ≥14 years.


Materials and Methods:
Data from 126 PD catheters were analyzed for NCs, including flow dysfunction, catheter leaks, hernias, bloody or chylous effluent, hydrocele, hydrothorax, and external catheter damage.


Results:

Among 126 catheters, 37 (29.4%) experienced 46 NCs, with outflow obstruction (32.6%), inflow/outflow issues (21.7%), leaks (21.7%), hernia (10.8%), bloody effluent (8.7%), and external catheter damage (6.5%) being the most common. Age, gender, and PD modality were not significantly associated with NCs, whereas icodextrin (extranel) use was protective (
P
= 0.048; odds ratio [OR] = 0.41). Most NCs occurred within 6 months (
P
< 0.001; OR = 19.1), and 52.2% required surgical intervention. Univariate analysis showed male gender and nonuse of icodextrin were linked to higher catheter removal, supported by Kaplan–Meier curves showing lower catheter survival in these groups. Overall, 29.2% required permanent catheter removal, 20.8% were managed with temporary hemodialysis and reinsertion, and the functional survival rate of PD catheters was 90.5%.



Conclusion:
NCs are frequent early in PD, often necessitating surgical intervention and leading to therapy discontinuation in one-third of cases. Early identification of high-risk patients and timely interventions, including icodextrin use and close monitoring of patients with diabetes or hypertension, are essential to optimize PD outcomes.