Outcome of all Tunneled Catheters for Dialysis Access: a Single Center Study
Muhammad Yasir Rafiq, Maj Gen Salman Saleem, Talha Haq Nawaz, Haroon Sabir, Aisha Haq Nawaz, Madiha Zafar
616
ABSTRACT
Renal
failure affects up to 18% of hospitalized patients and is associated with
significant morbidity, mortality, and resource utilization. Hemodialysis is
used mostly as renal replacement therapy method all over the world. Maintaining
a functioning upper extremity vascular access for a prolonged duration
continues to remain a challenge for dialysis providers.
Objective: The objective of this study was to determine the outcome of all tunneled
catheters placed in a single center for dialysis access over a period of six
months.
Study Design: Descriptive case series study
Setting:
Study
was conducted in Dialysis Department, Combined Military Hospital, Lahore.
Duration of Study: Present research was
conducted from 6th May 2019 to 5th Nov 2019.
Methodlogy: A total of 145
patients were enrolled after informed consent. Demographic information with
duration of hemodialysis was also noted. In all patients tunneled catheter was
placed for dialysis, by primary investigator. Then patients were followed-up
for 2 months and were assessed for catheter in next visit. If there was
redness, pain, and pus present then infection labeled. On assessment of
catheter condition, if it was found damaged, fell out, exposed cuff, or
fractures, blocked then catheter failure was noted. All this information was
recorded through proforma.
Results:
Mean age was 45.72 ± 15.31 years; Mean duration of
dialysis was 7.66 ± 2.93 months. Male were 53.8% and female were 46.2%.
Placement of catheter was at internal jugular 116 (80%) patients, at subclavian
21 (14.5%) and at femoral 8 (5.5%). Infection was present in 13.1% patients
while it was absent in 86.9% patients. Catheter failure was seen in 4.1%
patients, there was no significant association between presence of catheter
failure and age group, gender, BMI, duration of dialysis and site of catheter
having p-value = 0.322, 0.849, 0.741, 0.716 and 0.457 respectively. Significant
association was not found between presence of infection and age group, gender,
BMI, duration of dialysis and site of catheter having p-value = 0.591, 0.380,
0.081, 0.538 and 0.540 respectively.
Conclusion:
Presence
of Infection was observed in 13.1% patients and catheter failure was present in
4.1% patients with chronic kidney disease on maintenance hemodialysis. Effect
modifiers like age group, gender, BMI, duration of dialysis and site of
catheter did not show significant association.
Keywords:
Chronic
Kidney Disease, Infection, Catheter Failure, Hemodialysis.
ABSTRACT
Renal
failure affects up to 18% of hospitalized patients and is associated with
significant morbidity, mortality, and resource utilization. Hemodialysis is
used mostly as renal replacement therapy method all over the world. Maintaining
a functioning upper extremity vascular access for a prolonged duration
continues to remain a challenge for dialysis providers.
Objective: The objective of this study was to determine the outcome of all tunneled
catheters placed in a single center for dialysis access over a period of six
months.
Study Design: Descriptive case series study
Setting:
Study
was conducted in Dialysis Department, Combined Military Hospital, Lahore.
Duration of Study: Present research was
conducted from 6th May 2019 to 5th Nov 2019.
Methodlogy: A total of 145
patients were enrolled after informed consent. Demographic information with
duration of hemodialysis was also noted. In all patients tunneled catheter was
placed for dialysis, by primary investigator. Then patients were followed-up
for 2 months and were assessed for catheter in next visit. If there was
redness, pain, and pus present then infection labeled. On assessment of
catheter condition, if it was found damaged, fell out, exposed cuff, or
fractures, blocked then catheter failure was noted. All this information was
recorded through proforma.
Results:
Mean age was 45.72 ± 15.31 years; Mean duration of
dialysis was 7.66 ± 2.93 months. Male were 53.8% and female were 46.2%.
Placement of catheter was at internal jugular 116 (80%) patients, at subclavian
21 (14.5%) and at femoral 8 (5.5%). Infection was present in 13.1% patients
while it was absent in 86.9% patients. Catheter failure was seen in 4.1%
patients, there was no significant association between presence of catheter
failure and age group, gender, BMI, duration of dialysis and site of catheter
having p-value = 0.322, 0.849, 0.741, 0.716 and 0.457 respectively. Significant
association was not found between presence of infection and age group, gender,
BMI, duration of dialysis and site of catheter having p-value = 0.591, 0.380,
0.081, 0.538 and 0.540 respectively.
Conclusion:
Presence
of Infection was observed in 13.1% patients and catheter failure was present in
4.1% patients with chronic kidney disease on maintenance hemodialysis. Effect
modifiers like age group, gender, BMI, duration of dialysis and site of
catheter did not show significant association.
Keywords:
Chronic
Kidney Disease, Infection, Catheter Failure, Hemodialysis.