Blood Purification
Original Paper
Catheter Failure and Mortality in Hemodialysis Patients with Tunneled Cuffed Venous Catheters in a Single CenterShi M.a · Cui T.a · Ma L.a, b · Zhou L.a, b · Fu P.a, baDivision of Nephrology, Department of Internal Medicine, and bDivision of Nephrology, Kidney Research Institute, West China Hospital of Sichuan University, Chengdu, China
|
|
Log in to MyKarger to check if you already have access to this content.
KAB
Buy a Karger Article Bundle (KAB) and profit from a discount!
If you would like to redeem your KAB credit, please log in.
Save over 20% compared to the individual article price.
Article / Publication Details
Received: August 02, 2016
Accepted: December 12, 2016
Published online: January 31, 2017
Issue release date: April 2017
Number of Print Pages: 6
Number of Figures: 2
Number of Tables: 4
ISSN: 0253-5068 (Print)
eISSN: 1421-9735 (Online)
For additional information: https://www.karger.com/BPU
Abstract
Background: As of now, only a few studies have focused on the failure of tunneled cuffed venous catheter (tCVC) and mortality of hemodialysis (HD) patients using tCVC as long-term vascular access, whose vascular condition for arteriovenous fistula was not very satisfactory. In this study, we aimed to provide information about the first tCVC failure and survival rates of patients in this population. Methods: Fifty-nine patients who used tCVC from January 1, 2009 to December 31, 2014 in our HD center were analyzed in this retrospective study and followed up either until their death or until December 31, 2015. The first tCVC and patient survival rates were analyzed. Results: The incidence of catheter-related infections was 0.3 per 1,000 patient-days. The median survival duration of first tCVC was 45.0 (95% CI 29.3-69.7) months and the median survival time of all patients was 56.3 (95% CI 34.1-78.5) months by Kaplan-Meier analysis. Advanced age (hazard ratio [HR] 1.055, p < 0.05) and diabetic mellitus (HR 4.147, p < 0.05) at the initiation of HD were significant risk factors of first tCVC failure, while male (HR 2.712, p < 0.05) and cardiovascular diseases (CVDs; HR 4.139, p < 0.05) were significant risk factors for patient mortality as deduced by Cox proportional hazards methods. Conclusions: The study highlighted that first tCVC survival rates and patient survival rates were high in HD patients who were using tCVCs as long-term vascular access, with low incidence of catheter-related infections. In the study it was found that advanced age and diabetic mellitus at the initiation of HD influenced first tCVC failure, whereas male and CVDs seemed to be risk factors for patient mortality.
© 2017 S. Karger AG, Basel
References
-
US Renal Data System: USRDS 2015 Annual Data Report: Atlas of Chronic Kidney Disease and End-Stage Renal Disease in the United States. Bethesda, National Intstitutes of Health, National Institutes of Diabetes and Digestive and Kidney Disease, 2015.
-
Hong DQ, He Q, Pu L, Deng F, Yang HL, Li GS, Wang L: Study on mortality of hemodialysis patients of Sichuan province in 2011. Chin J Blood Purif 2011;11:575-578.
- Woo K, Yao J, Selevan D, Hye RJ: Influence of vascular access type on sex and ethnicity-related mortality in hemodialysis-dependent patients. Perm J 2012;16:4-9.
- Quarello F, Forneris G, Borca M, Pozzato M: Do central venous catheters have advantages over arteriovenous fistulas or grafts? J Nephrol 2006;19:265-279.
- Schwab SJ, Beathard G: The hemodialysis catheter conundrum: hate living with them, but can't live without them. Kidney Int 1999;56:1-17.
- Work J: Hemodialysis catheters and ports. Semin Nephrol 2002;22:211-220.
- Alomari AI, Falk A: The natural history of tunneled hemodialysis catheters removed or exchanged: a single-institution experience. J Vasc Interv Radiol 2007;18:227-235.
- Bray BD, Boyd J, Daly C, Donaldson K, Doyle A, Fox JG, Innes A, Khan I, Peel RK, Severn A, Shilliday I, Simpson K, Stewart GA, Traynor J, Metcalfe W: Vascular access type and risk of mortality in a national prospective cohort of haemodialysis patients. QJM 2012;105:1097-1103.
- Bradbury BD, Chen F, Furniss A, Pisoni RL, Keen M, Mapes D, Krishnan M: Conversion of vascular access type among incident hemodialysis patients: description and association with mortality. Am J Kidney Dis 2009;53:804-814.
- Lacson E Jr, Wang W, Lazarus JM, Hakim RM: Change in vascular access and mortality in maintenance hemodialysis patients. Am J Kidney Dis 2009;54:912-921.
- Roca-Tey R, Arcos E, Comas J, Cao H, Tort J: Starting hemodialysis with catheter and mortality risk: persistent association in a competing risk analysis. J Vasc Access 2016;17:20-28.
- Zhu M, Zhang W, Zhou W, Zhou Y, Fang Y, Wang Y, Zhang H, Yan Y, Ni Z, Qian J: Initial hemodialysis with a temporary catheter is associated with complications of a later permanent vascular access. Blood Purif 2014;37:131-137.
- Frankenfield DL, Ramirez SP, McClellan WM, Frederick PR, Rocco MV: Differences in intermediate outcomes for Asian and non-Asian adult hemodialysis patients in the United States. Kidney Int 2003;64:623-631.
- Mandolfo S, Acconcia P, Bucci R, Corradi B, Farina M, Rizzo MA, Stucchi A: Hemodialysis tunneled central venous catheters: five-year outcome analysis. J Vasc Access 2014;15:461-465.
- Lok CE, Mokrzycki MH: Prevention and management of catheter-related infection in hemodialysis patients. Kidney Int 2011;79:587-598.
- Joshi AJ, Hart PD: Antibiotic catheter locks in the treatment of tunneled hemodialysis catheter-related blood stream infection. Semin Dial 2013;26:223-226.
- Poole CV, Carlton D, Bimbo L, Allon M: Treatment of catheter-related bacteraemia with an antibiotic lock protocol: effect of bacterial pathogen. Nephrol Dial Transplant 2004;19:1237-1244.
- Shingarev R, Barker-Finkel J, Allon M: Natural history of tunneled dialysis catheters placed for hemodialysis initiation. J Vasc Interv Radiol 2013;24:1289-1294.
- Valliant AM, Chaudhry MK, Yevzlin AS, Astor B, Chan MR: Tunneled dialysis catheter exchange with fibrin sheath disruption is not associated with increased rate of bacteremia. J Vasc Access 2015;16:52-56.
- Myers DD Jr: Pathophysiology of venous thrombosis. Phlebology 2015;30(1 suppl):7-13.
- Tian XL, Li Y: Endothelial cell senescence and age-related vascular diseases. J Genet Genomics 2014;41:485-495.
- Bradbury BD, Fissell RB, Albert JM, Anthony MS, Critchlow CW, Pisoni RL, Port FK, Gillespie BW: Predictors of early mortality among incident US hemodialysis patients in the Dialysis Outcomes and Practice Patterns Study (DOPPS). Clin J Am Soc Nephrol 2007;2:89-99.
- Bloembergen WE, Port FK, Mauger EA, Wolfe RA: Causes of death in dialysis patients: racial and gender differences. J Am Soc Nephrol 1994;5:1231-1242.
Article / Publication Details
Received: August 02, 2016
Accepted: December 12, 2016
Published online: January 31, 2017
Issue release date: April 2017
Number of Print Pages: 6
Number of Figures: 2
Number of Tables: 4
ISSN: 0253-5068 (Print)
eISSN: 1421-9735 (Online)
For additional information: https://www.karger.com/BPU
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
Get Permission
PubMed ID
