# The association between embedded catheter implantation and hospitalization costs for peritoneal dialysis initiation: a retrospective cohort study

## TL;DR

This study found that embedding PD catheters during peritoneal dialysis initiation reduces hospital costs and stays, especially for younger patients.

## Contribution

The study identifies catheter embedding as a cost-effective and efficient method for PD initiation, particularly in young-to-middle-aged patients.

## Key findings

- Catheter embedding was associated with lower hospitalization costs compared to conventional insertion.
- Catheter embedding reduced the length of hospitalization for PD initiation.
- The benefits of catheter embedding were more pronounced in young-to-middle-aged patients.

## Abstract

Compared with the conventional peritoneal dialysis (PD) catheter insertion, embedding PD catheter implantation is one of the procedures for planned PD initiation. However, facilities where embedded PD catheter implantation is available are limited, and the impact of embedded PD catheter implantation on hospitalization cost and length of hospitalization is unknown.

This retrospective single-center cohort study included 132 patients with PD initiation between 2005 and 2020. The patients were divided into two groups: 64 patients in the embedding group and 68 patients in the conventional insertion group. We created a multivariable generalized linear model (GLM) with the gamma family and log-link function to evaluate the association among catheter embedding, the duration and medical costs of hospitalization for PD initiation. We also evaluated the effect modification between age and catheter embedding.

Catheter embedding (β coefficient − 0.13 [95% confidence interval − 0.21, − 0.05]) and age (per 10 years 0.08 [0.03, 0.14]) were significantly associated with hospitalization costs. Catheter embedding (− 0.21 [− 0.32, − 0.10]) and age (0.11 [0.03, 0.19]) were also identified as factors significantly associated with length of hospitalization. The difference between the embedding group and the conventional insertion group in hospitalization costs for PD initiation (P for interaction = 0.060) and the length of hospitalization (P for interaction = 0.027) was larger in young-to-middle-aged patients than in elderly patients.

Catheter embedding was associated with lower hospitalization cost and shorter length of hospitalization for PD initiation than conventional PD catheter insertion, especially in young-to-middle-aged patients.