Predictors of Nephrostomy Catheter Dislodgement: Insights from a Retrospective Analysis.

PURPOSE

To identify the anatomical and technical factors associated with unintended nephrostomy catheter dislodgement (NCD).

MATERIALS AND METHODS

A retrospective review of 742 percutaneous nephrostomy (PCN) procedures carried out between June 2020 and June 2024 was conducted. Thirty-eight patients with spontaneous NCD were assigned to the dislodgement group, and 38 matched controls were selected using propensity score matching.. Key measurements included cortex-to-skin distance, paravertebral muscle area, psoas muscle area, subcutaneous fat thickness, and renal parenchymal thickness.

RESULTS

Patients with NCD were similar in age and sex. No significant differences were observed in subcutaneous fat thickness, muscle thickness, or renal parenchymal thickness between the groups. However, cortex-to-skin distance was significantly shorter in the NCD group (p = 0.001). ROC analysis identified an optimal threshold of 46.65 mm for cortex-to-skin distance, with a sensitivity of 92.1%, specificity of 39.5%, and a positive predictive value of 60.3% (AUC = 0.67).

CONCLUSION

Shorter cortex-to-skin distance is a key predictor of NCD. Patients with shorter cortex-to-skin distances, may benefit from closer monitoring and targeted preventive measures to reduce the risk of dislodgement.