Independent Predictors of Tunneled Haemodialysis Catheter Dysfunction and Reduced Patency: A Retrospective Cohort...

Tunneled cuffed catheters (TCCs) are vital haemodialysis access devices in chronic kidney disease (CKD), yet prone to significant dysfunction-related morbidity.

To identify bedside patient-related predictors of TCC dysfunction and reduced patency in adult CKD patients undergoing haemodialysis at a single Indonesian center.

Single-center retrospective cohort study at Rasyida Kidney Hospital, Medan, Indonesia, covering TCC insertions from 2021 to 2024.

Primary outcomes were catheter dysfunction and patency. Variables were extracted from medical records.

Multivariable logistic regression identified predictors of dysfunction; Cox proportional hazards regression assessed reduced patency.

A total of 102 TCCs in 96 adult patients were included. Mean age was 62.7 ± 14.9 years and 62.7% were female. Dysfunction occurred in 30 catheters (29.4%) over a mean dwell time of 20.1 ± 13.1 months. Independent predictors of dysfunction were femoral insertion site (aOR 3.56, 95% CI 1.08-11.7, p = 0.036) and hypertension (aOR 3.34, 95% CI 1.01-11.1, p = 0.049). Cox regression confirmed femoral site (aHR 3.10, 95% CI 1.29-7.44, p = 0.011), hypertension (aHR 4.45, 95% CI 1.40-14.15, p = 0.011), and age ≥ 60 years (aHR 3.96, 95% CI 1.48-10.64, p = 0.006) as predictors of reduced patency.

Femoral insertion site and hypertension were strong independent predictors of TCC dysfunction and shortened patency. Age ≥ 60 years additionally predicted reduced patency. These simple bedside factors support practical risk stratification in low-resource haemodialysis settings.