[Tunneled dialysis catheters placement program in Clinical Hospital Merkur]

Tunneled dialysis catheters are one of the methods for vascular access in hemodialysis patients. In the Clinical Hospital Merkur placement of tunneled dialysis catheters was started in 2007. The aim of this study was to analyze results of that program.

We analyzed survival of tunneled dialysis catheters placed in our Division of nephrology from January 2009. to April 2011. First site of choice for placement of catheter was right jugular vein. Catheters were placed de novo or as over the wire exchange of a previous catheter. Catheters were placed under fluoroscopy guidance. Survival was analyzed using Kaplan-Meier analysis. Difference between survivals was tested by the log-rank test.

88 catheters have been placed in 70 patients. Cumulative 1- year catheter survival, censored for patient death was 58%. 1-year catheter survival analyzed by the location of placement was as follows: jugular veins 70%. right subclavian vein 58%, left subclavian vein 43% and femoral veins 33%. Left jugular vein and femoral veins had lower survival rate in comparison with jugular veins (p=0.057). There was no statistical difference in catheter survival with respect to placement de novo or after over the wire exchange (p=0,516).

Jugular veins are best location for placement of tunneled dialysis catheter. There is no statistical difference of catheter survival after placement de novo or after over the wire exchange in the presence of previous catheter.