Analysis of complications related to dialysis catheters in cancer patients

Abstract

Background: Data on renal replacement therapy (RRT) in cancer patients with acute kidney injury (AKI) in the intensive care unit (ICU) and how these factors influence the efficiency of dialysis and the outcomes of these patients are scarce. We aim to describe the predictive clinical characteristics of hemodialysis catheter-related complications in critically ill cancer patients with acute kidney injury. Methods: This is a retrospective cohort study of 62 cancer patients subjected to short-term hemodialysis catheter implants. We evaluated the clinical characteristics of patients and the complications related to catheter implantation: mild malfunction, characterized by reversal of access lines; infections; and catheter replacement due to severe malfunction or infections. The outcomes analyzed were recovery of renal function, discharge from the ICU, and death. Results: The most frequent complications were related to mild malfunction, which justified dialysis line reversal in 21.3% of the patients. The complication rate was higher in patients undergoing conventional hemodialysis, in those with coronary disease, and in those who had more than three dialysis sessions. The presence of metastasis was more frequently related to catheter reversals. Patients with mild or severe malfunction were more likely to be hospitalized for more than 18 days in the ICU. All patients with mild malfunction had hospitalization times greater than 28 days. Conclusions: Hemodialysis catheter-related complications were associated with longer ICU and hospital stays in cancer patients with AKI. Mild malfunction of the hemodialysis catheter was the most frequent complication. Patients with metastasis and sepsis, who used diuretics, and who used intermittent dialysis methods had milder catheter malfunctions.