Risk Factors Associated with Dysfunction of Permanent Tunneled Cuffed Hemodialysis Catheters; Single Center Experience
Öz
Risk Factors Associated with Dysfunction of Permanent Tunneled Cuffed Hemodialysis Catheters; Single Center Experience
Introduction: Permanent tunneled cuffed catheters are frequently preferred for hemodialysis in patients with chronic renal failure (CRF), but the factors associated with the dysfunction of these catheters are not well known. Our goal is to investigate these risk factors.
Materials and Methods: All cases with a diagnosis of CRF and a permanent tunneled cuffed catheter inserted into the central vein for the first time in our radiology clinic between 2014 and 2019 and who developed catheter dysfunction were included in the study. Demographic and clinical data of the cases were obtained from file records. The relationship between the causes of catheter dysfunction and the presence of diabetes and hypertension was investigated.
Results: Of the total 123 cases, 78 (63.4%) were male, 45 (36.6%) were female, the median age was 55 (28-78). Twenty-nine (23.6%) of the cases had thrombosis, 72 (58.5%) had venous stenosis and 22 (17.9%) had catheter dysfunction due to fibrin sheath. Dysfunction groups were compared with each other in terms of age, gender, duration of operation of the catheter, CRF etiology, comorbid diseases, the vein where the catheter was placed and the use of anticoagulants. The most important cause of catheter dysfunction in the early period was thrombosis (p = 0.003). When the causes of dysfunction were examined, the most common causes of dysfunction were venous stenosis in patients with hypertension, thrombosis in patients with diabetes as a concomitant disease without diabetes in the etiology of CRF, and thrombosis in patients with diabetes in CRF etiology (p <0.001). In addition, it was found that catheter dysfunction due to thrombosis developed less in patients using anticoagulants (p <0.001). There was no statistically significant difference between the groups in terms of other parameters (p> 0.05).
Conclusion: The use of low-dose anticoagulants plays a protective role against thrombosis. The use of low-dose anticoagulants in patients without contraindications, especially in diabetic patients, may reduce especially early catheter dysfunction.
Anahtar Kelimeler
fibrin hemodialysis permanent tunneledcuffed hemodialysis catheter stenosis thrombosis
Kaynakça
- 1. Bream PR Jr. Update on insertion and complications of central venous catheters for hemodialysis. Semin Intervent Radiol. 2016; 33(1): 31–38.
- 2. Quarello F, Forneris G, Borca M et al: Do central venous catheters have advantages over arteriovenous fistulas or grafts? J Nephrol. 2006; 19: 265–79.
- 3. Labriola L, Pochet JM. Any use for alternative lock solutions in the prevention of catheter-related blood stream infections? J. Vasc Access. 2017; 18; 34–38.
- 4. Ibeas-Lopez, J. New technology: Heparyn and atimicrobial-coated catheters. J. Vasc Access. 2015; 16; 48–53.
- 5. Lok C, Huber T, Lee T, Shenoy S et al. KDOQI Clinical Practice Guidelines for Vascular Access: 2019 Update. Am J Kidney Dis. 2020; 75; 1─64.
- 6. Timsit JF. What is the best site for central venous catheter insertion in critically ill patients. Crit Care. 2003; 7(6): 397399.
- 7. Kelber J, Delmez JA, Wındus Dw. Factors affecting delivery of high-efficiency dialysis using temporary vascular access. Am J Kidney Dis. 1993; 22: 24 ̶ 29.
- 8. Rathi M, Pinnamaneni VST, Sakhuja V. Non-imaging assisted insertion of un-cuffed, non-tunneled internal jugular venous catheters for hemodialysis: safety and utility in modern day world. Biomed J. 2016; 39(4): 283–88.
- 9. Maya ID, Allon M. Outcomes of tunneled femoral hemodialysis catheters: comparison with internal jugular vein catheters. Kidney Int. 2015; 68: 2886–89.
- 10. Engstrom BI, Horvath JJ, Stewart JK et al. Tunneled internal jugular hemodialysis catheters: impact of laterality and tip position on catheter dysfunction and infection rates. J Vasc Interv Radiol. 2013; 24(9): 1295–1302.
- 11. Shingarev R, Barker-Finkel J, Allon M: Natural history of tunneled dialysis catheters placed for hemodialysis initiation. J Vasc Interv Radiol. 2013; 24: 1289–94.
- 12. Shi M, Cui T, Ma L et al. Catheter Failure and Mortality in Hemodialysis Patients with Tunneled Cuffed Venous Catheters in a Single Center. Blood Purif. 2017; 43(4): 321 ̶ 26.
- 13. Coentrao L, Santos-Araujo C, Dias C et al. Effects of starting hemodialysis with an arteriovenous fistula or central venous catheter compared with peritoneal dialysis: a retrospective cohort study. BMC Nephrol. 2012; 13: 88.
- 14. Ponce D, Mendes M, Silva T et.al. Occluded Tunneled Venous Catheter in Hemodialysis Patients: Risk Factors and Efficacy of Alteplase. 2015; 39(9): 741-47.
- 15. Wang K, Wang P, Liang X et.al. Epidemiology of haemodialysis catheter complications: A survey of 865 dialysis patients from 14 haemodialysis centres in Henan province in China. BMJ Open. 2015; 5(11): e007136.
- 16. Szarnecka-Sojda A, Jacheć W, Polewczyk M et.al. Risk of Complications and Survival of Patients Dialyzed with Permanent Catheters. Medicina (Kaunas). 2019; 56(1): 2.
- 17. Fox J, Joubert G, Loggenberg E. Tunnelled haemodialysis catheters in central Free State: Epidemiology and complications. SA J Radiol. 2019; 23(1): 1791.
- 18. Valliant AM, Chaudhry MK, Yevzlin AS et.al: Tunneled dialysis catheter exchange with fibrin sheath disruption is not associated with increased rate of bacteremia. J Vasc Access. 2015; 16: 52–56.
- 19. Vats HS. Complications of catheters: tunneled and non-tunneled. Adv Chronic Kidney Dis. 2012; 19(3): 188-94.
- 20. Campean V, Neureiter D, Varga Iet al. Atherosclerosis and vascular calcification in chronic renal failure. Kidney Blood Press Res. 2005; 28: 280–89.
- 21. Afzal A, Haq AU, Ahmed A et al. Hemodialysis patients; Central vein stenosis following temporary double lumen catheterization in internal jugular and subclavian veins. Professional Med J. 2017; 24(8): 1211-15.
- 22. Schon D, Whittman D. Managing the complications of long-term tunneled dialysis catheters. Semin Dial. 2003; 16(04): 314–22.
- 23. Rackoff WR, Weıman J, Jakobowskı D et al. A randomised, controlled trial of the efficacy of a heparin and vancomycin solution in preventing central venous catheter infections in children. j pediatr 1995; 127: 147e151.
- 24. Bern MM, Lokıch JJ, Wallach SR et al. Very low doses of warfarin can prevent thrombosis in central vein catheters. Ann Intern Med 1990; 112: 423e428.
Öz
Kaynakça
- 1. Bream PR Jr. Update on insertion and complications of central venous catheters for hemodialysis. Semin Intervent Radiol. 2016; 33(1): 31–38.
- 2. Quarello F, Forneris G, Borca M et al: Do central venous catheters have advantages over arteriovenous fistulas or grafts? J Nephrol. 2006; 19: 265–79.
- 3. Labriola L, Pochet JM. Any use for alternative lock solutions in the prevention of catheter-related blood stream infections? J. Vasc Access. 2017; 18; 34–38.
- 4. Ibeas-Lopez, J. New technology: Heparyn and atimicrobial-coated catheters. J. Vasc Access. 2015; 16; 48–53.
- 5. Lok C, Huber T, Lee T, Shenoy S et al. KDOQI Clinical Practice Guidelines for Vascular Access: 2019 Update. Am J Kidney Dis. 2020; 75; 1─64.
- 6. Timsit JF. What is the best site for central venous catheter insertion in critically ill patients. Crit Care. 2003; 7(6): 397399.
- 7. Kelber J, Delmez JA, Wındus Dw. Factors affecting delivery of high-efficiency dialysis using temporary vascular access. Am J Kidney Dis. 1993; 22: 24 ̶ 29.
- 8. Rathi M, Pinnamaneni VST, Sakhuja V. Non-imaging assisted insertion of un-cuffed, non-tunneled internal jugular venous catheters for hemodialysis: safety and utility in modern day world. Biomed J. 2016; 39(4): 283–88.
- 9. Maya ID, Allon M. Outcomes of tunneled femoral hemodialysis catheters: comparison with internal jugular vein catheters. Kidney Int. 2015; 68: 2886–89.
- 10. Engstrom BI, Horvath JJ, Stewart JK et al. Tunneled internal jugular hemodialysis catheters: impact of laterality and tip position on catheter dysfunction and infection rates. J Vasc Interv Radiol. 2013; 24(9): 1295–1302.
- 11. Shingarev R, Barker-Finkel J, Allon M: Natural history of tunneled dialysis catheters placed for hemodialysis initiation. J Vasc Interv Radiol. 2013; 24: 1289–94.
- 12. Shi M, Cui T, Ma L et al. Catheter Failure and Mortality in Hemodialysis Patients with Tunneled Cuffed Venous Catheters in a Single Center. Blood Purif. 2017; 43(4): 321 ̶ 26.
- 13. Coentrao L, Santos-Araujo C, Dias C et al. Effects of starting hemodialysis with an arteriovenous fistula or central venous catheter compared with peritoneal dialysis: a retrospective cohort study. BMC Nephrol. 2012; 13: 88.
- 14. Ponce D, Mendes M, Silva T et.al. Occluded Tunneled Venous Catheter in Hemodialysis Patients: Risk Factors and Efficacy of Alteplase. 2015; 39(9): 741-47.
- 15. Wang K, Wang P, Liang X et.al. Epidemiology of haemodialysis catheter complications: A survey of 865 dialysis patients from 14 haemodialysis centres in Henan province in China. BMJ Open. 2015; 5(11): e007136.
- 16. Szarnecka-Sojda A, Jacheć W, Polewczyk M et.al. Risk of Complications and Survival of Patients Dialyzed with Permanent Catheters. Medicina (Kaunas). 2019; 56(1): 2.
- 17. Fox J, Joubert G, Loggenberg E. Tunnelled haemodialysis catheters in central Free State: Epidemiology and complications. SA J Radiol. 2019; 23(1): 1791.
- 18. Valliant AM, Chaudhry MK, Yevzlin AS et.al: Tunneled dialysis catheter exchange with fibrin sheath disruption is not associated with increased rate of bacteremia. J Vasc Access. 2015; 16: 52–56.
- 19. Vats HS. Complications of catheters: tunneled and non-tunneled. Adv Chronic Kidney Dis. 2012; 19(3): 188-94.
- 20. Campean V, Neureiter D, Varga Iet al. Atherosclerosis and vascular calcification in chronic renal failure. Kidney Blood Press Res. 2005; 28: 280–89.
- 21. Afzal A, Haq AU, Ahmed A et al. Hemodialysis patients; Central vein stenosis following temporary double lumen catheterization in internal jugular and subclavian veins. Professional Med J. 2017; 24(8): 1211-15.
- 22. Schon D, Whittman D. Managing the complications of long-term tunneled dialysis catheters. Semin Dial. 2003; 16(04): 314–22.
- 23. Rackoff WR, Weıman J, Jakobowskı D et al. A randomised, controlled trial of the efficacy of a heparin and vancomycin solution in preventing central venous catheter infections in children. j pediatr 1995; 127: 147e151.
- 24. Bern MM, Lokıch JJ, Wallach SR et al. Very low doses of warfarin can prevent thrombosis in central vein catheters. Ann Intern Med 1990; 112: 423e428.
Ayrıntılar
| Birincil Dil | İngilizce |
|---|---|
| Konular | Radyoloji ve Organ Görüntüleme |
| Bölüm | Araştırma Makaleleri |
| Yazarlar | |
| Yayımlanma Tarihi | 1 Temmuz 2021 |
| Gönderilme Tarihi | 23 Şubat 2021 |
| Yayımlandığı Sayı | Yıl 2021Cilt: 12 Sayı: 3 |
