UNRESOLVED ISSUES IN DIALYSIS: Long‐Term Management of the Tunneled Venous Catheter

Liangos, Orfeas; Gul, Ambreen; Madias, Nicolaos E.; Jaber, Bertrand L.

doi:10.1111/j.1525-139x.2006.00143.x

Cited by 70 publications

(58 citation statements)

References 85 publications

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“…In addition, some stable patients had acute worsening kidney function that was not predictable, resulting in an urgent need for dialysis. CVC continues to be the most common urgent-start dialysis access, representing approximately 80% of all accesses [3]; however, multiple studies have demonstrated a variety of complications associated with the placement and use of CVC, including catheter-related infections, thromboses, catheter malfunction, and hemodynamic instability, resulting in a negative effect on patient survival [16–18]. Lee et al [19] reported that the risk of CVC-related infection is close to 50% by 6 months.…”

Section: Discussionmentioning

confidence: 99%

Urgent-Start Peritoneal Dialysis and Hemodialysis in ESRD Patients: Complications and Outcomes

et al. 2016

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BackgroundSeveral studies have suggested that urgent-start peritoneal dialysis (PD) is a feasible alternative to hemodialysis (HD) in patients with end-stage renal disease (ESRD), but the impact of the dialysis modality on outcome, especially on short-term complications, in urgent-start dialysis has not been directly evaluated. The aim of the current study was to compare the complications and outcomes of PD and HD in urgent-start dialysis ESRD patients.MethodsIn this retrospective study, ESRD patients who initiated dialysis urgently without a pre-established functional vascular access or PD catheter at a single center from January 2013 to December 2014 were included. Patients were grouped according to their dialysis modality (PD and HD). Each patient was followed for at least 30 days after catheter insertion (until January 2016). Dialysis-related complications and patient survival were compared between the two groups.ResultsOur study enrolled 178 patients (56.2% male), of whom 96 and 82 patients were in the PD and HD groups, respectively. Compared with HD patients, PD patients had more cardiovascular disease, less heart failure, higher levels of serum potassium, hemoglobin, serum albumin, serum pre-albumin, and lower levels of brain natriuretic peptide. There were no significant differences in gender, age, use of steroids, early referral to a nephrologist, prevalence of primary renal diseases, prevalence of co-morbidities, and other laboratory characteristics between the groups. The incidence of dialysis-related complications during the first 30 days was significantly higher in HD than PD patients. HD patients had a significantly higher probability of bacteremia compared to PD patients. HD was an independent predictor of short-term (30-day) dialysis-related complications. There was no significant difference between PD and HD patients with respect to patient survival rate.ConclusionIn an experienced center, PD is a safe and feasible dialysis alternative to HD for ESRD patients with an urgent need for dialysis.

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Section: Discussionmentioning

confidence: 99%

Urgent-Start Peritoneal Dialysis and Hemodialysis in ESRD Patients: Complications and Outcomes

et al. 2016

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“…2 Nevertheless, late complications-particularly infection and thrombosis-remain problematic and can lead to catheter dysfunction and significant morbidity. [6][7][8] To the best of the authors' knowledge, no local data yet exist from Oman regarding the safety of radiological catheter placement and the prevalence of catheter-related complications. This study therefore aimed to assess the technical success, safety and immediate and delayed complications of ultrasound-and fluoroscopy-guided TVCs at SQUH.…”

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confidence: 99%

Safety and Complications of Double-Lumen Tunnelled Cuffed Central Venous Dialysis Catheters: Clinical and radiological perspective from a tertiary centre in Oman

Hamid¹,

Kakaria²,

Khan³

et al. 2015

SQUMJ

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abstract:Objectives: This study aimed to assess the technical success, safety and immediate and delayed complications of double-lumen tunnelled cuffed central venous catheters (TVCs) at the Sultan Qaboos University Hospital (SQUH), Muscat, Oman. Methods: This retrospective study took place between January 2012 and October 2013. The clinical records and radiological data of all patients who underwent ultrasound-and fluoroscopy-guided TVC placement at SQUH during the study period were reviewed. Demographic data and information regarding catheter placement, technical success and peri-and post-procedure complications (such as catheter-related infections or thrombosis) were collected. Results: A total of 204 TVCs were placed in 161 patients. Of these, 68 were female (42.2%) and 93 were male (57.8%). The mean age of the patients was 54.4 ± 17.3 years. The most common reason for catheter placement was the initiation of dialysis (63.4%). A total of 203 procedures were technically successful (99.5%). The right internal jugular vein was the most common site of catheter placement (74.9%). Mild haemorrhage which resolved spontaneously occurred in 11 cases (5.4%). No other complications were observed. Subsequent follow-up data was available for 132 catheters (65.0%); of these, thrombosis-related catheter malfunction was observed in 22 cases (16.7%) and catheter-related infection in 29 cases (22.0%). Conclusion: Radiological-guided placement of tunnelled haemodialysis catheters can be performed safely with excellent technical success. The success rate of catheter insertion at SQUH was favourable in comparison with other studies reported in the literature.

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“…If these therapies do not restore adequate QB, a referral is made to the interventional center for catheter exchange. Current therapy once the patient is referred to the interventional center for dysfunction TDC owing to an inadequate QB is summarized in Table 2 (7).…”

Section: Treatment Of Thrombosis and Fibrin Sheath Formationmentioning

confidence: 99%

The Catheter‐Challenged Patient and the Need to Recognize the Recurrently Dysfunctional Tunneled Dialysis Catheter

Rasmussen

2010

Seminars in Dialysis

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Tunneled dialysis catheters (TDC) become dysfunctional because of placement problems, infection, thrombosis, and fibrin sheath formation. Occasional patients who are catheter dependant develop frequent catheter dysfunction because of thrombosis or thrombosis associated with fibrin sheath formation. This article attempts to define which dysfunctional catheters because of thrombosis and thrombosis associated with fibrin sheath formation actually represent a recurrently dysfunctional TDC (RDC) and puts forth an approach to managing the RDC.

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UNRESOLVED ISSUES IN DIALYSIS: Long‐Term Management of the Tunneled Venous Catheter

Cited by 70 publications

References 85 publications

Urgent-Start Peritoneal Dialysis and Hemodialysis in ESRD Patients: Complications and Outcomes

Urgent-Start Peritoneal Dialysis and Hemodialysis in ESRD Patients: Complications and Outcomes

Safety and Complications of Double-Lumen Tunnelled Cuffed Central Venous Dialysis Catheters: Clinical and radiological perspective from a tertiary centre in Oman

The Catheter‐Challenged Patient and the Need to Recognize the Recurrently Dysfunctional Tunneled Dialysis Catheter

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