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Temporary vascular catheters for hemodialysis: a 3-year prospective study
R T Naumovic1, D B Jovanovic, L J D Djukanovic
1Clinic of Nephrology, Institute of Urology and Nephrology, Clinical Center of Serbia, Belgrade - Serbia and Montenegro. rnaumovic@drenik.net
The International Journal of Artificial Organs
|November 25, 2004
Summary
Temporary hemodialysis catheters are crucial for uremia patients. Catheter related bacteremia (CRB) is the main complication, with duration of use and dialysis number increasing risk. Jugular catheters show longer survival than femoral.
Area of Science:
- Nephrology
- Vascular Access
- Infectious Diseases
Background:
- Temporary hemodialysis catheters are essential for uremia management.
- Catheter-related complications are a significant source of morbidity in end-stage renal disease (ESRD) patients.
- Optimal venous access and risk factors for complications remain unclear.
Purpose of the Study:
- To prospectively evaluate complications associated with temporary hemodialysis catheter insertion.
- To identify risk factors for catheter-related bacteremia (CRB).
- To compare outcomes between jugular (JC) and femoral (FC) catheter sites.
Main Methods:
- Prospective examination of 107 consecutive patients requiring temporary hemodialysis catheters.
- Data collection on catheter insertion site (jugular vs. femoral), duration, and complications.
- Statistical analysis including Cox proportional hazard models to assess risk factors.
Main Results:
- Early complications were infrequent. Catheter-related bacteremia (CRB) was the most common late complication.
- Staphylococcus aureus was the most frequent pathogen. Risk of CRB increased with catheter duration and number of dialyses.
- Jugular catheters demonstrated significantly longer actuarial survival compared to femoral catheters.
Conclusions:
- CRB is the primary late complication, with similar frequency for jugular and femoral sites.
- Catheter dwell time and dialysis frequency are key risk factors for CRB.
- Jugular venous access is associated with better long-term outcomes than femoral access for temporary hemodialysis catheters.