Purpose: Due to high prevalence of diabetes mellitus and subsequent nephropathy, the need for access to start and continue dialysis has been increased. In this study, we aim to study the efficacy and complications of non-tunneled catheters (NTC) till fistula maturation because of being easy and cheap implementation as well as similar complications compared to tunneled catheters (TC).
Materials and Methods: In this retrospective observational study, 247 patients with first-time AVF creation referred to Vascular Surgery Centre of Mashhad University of Medical Sciences, Iran, were recruited since March 2016 to December 2017. Only 153 patients who have completed the study, and were monitored every two weeks in case of un-maturation along with the status of temporary catheters.
Results: Mean age of patients was 49.9 ± 7.74 years, and 75 (49%) were females, which was comparable with literature. Preference of NTC implementation was at right jugular because of the easy access to central vein and less chance of complications. Catheter location was at right internal jugular in 61.4% of the patients. Out of 24 femoral cases, 18 was done at femoral. AVF location was done at left/right cubital in most cases (52.3%). The rate of infection was 15.0%, which was less than NTC’s infections reported in the literature.
Conclusion: Use of non-tunneled catheter in the form of outpatient in the period of AVF maturation time is recommended
due to similar complication rate.
- Sidawy AP, Preler BA. Rutherford’s vascular surgery and endovascular therapy, vol 2, 9th edition. ELSEVIER; 2018. p. 175-2288
- U.S. Renal Data System: USRDS 2011 Annual Data Report: Atlas of End-Stage Renal Disease in the United States. Bethesda, MD: National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases; 2011. Available at: http://www.usrds.org/ 2011/view/default.asp. Accessed April 2, 2012
- National Kidney Foundation K/DOQI clinical practice guidelines for vascular access: Update 2000.Am J Kidney Dis.2001;37:S137-S181. Available at: http://www.kidney.org/professionals/KDOQI/guideline_upHD_PD_VA/index.htm. Accessed April 2, 2012.
- Vascular Access 2006 Work Group. Clinical practice guidelines for vascular access. Am J Kidney Dis. 2006; 48:S176–S273.
- Vats HS. Complications of catheters: tunneled and non-tunneled. Adv Chronic Kidney Dis. 2012;19(3):188-194.
- Fiaccadori E, Gonzi G, Zambrelli P, Tortorella G. Cardiac arrhythmias during central venous catheter procedures in acute renal failure: a prospective study. J Am Soc Nephrol. 1996;7(7):1079-1084.
- Bessereau J, Genotelle N, Chabbaut C, et al. Long-term outcome of iatrogenic gas embolism. Intensive Care Med. 2010; 36:1180-1187
- Levit RD, Cohen RM, Kwak A, et al. Asymptomatic central venous stenosis in hemodialysis patients. Radiology. 2006;238:1051-1056.
- Khwaja A. KDIGO clinical practice guidelines for acute kidney injury. Nephron Clin Pract. 2012;120(4):c179-c184.
- Barrett N, Spencer S, Mclvor J, Brown EA. Subclavian stenosis: a major complication of subclavian dialysis catheters. Nephrol Dial Transplant. 1988; 3:423–425
- Borja AR. Current status of infra-clavicular subclavian vein catheterization: Review of the English literature. Ann Thorac Surg. 1972;13:615-624
- Farrell J, Walshe J, Gellens M, Martin KJ. Complications associated with insertion of jugular venous catheters for hemodialysis: the value of post procedural radiograph. Am J Kidney Dis. 1997; 30:690-692.
- From Division of Nephrology, Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI. Advances in Chronic Kidney Disease, Vol 19, No 3 (May), 2012: pp 188-194
- Chan MR. Hemodialysis central venous catheter dysfunction. Semin dial. 2008;21:516-521.
- Maya ID. Antibiotic lock for treatment of tunneled hemodialysis catheter bacteremia. Semin Dial. 2008; 21:539-541.
- Lok CE,Mokrzycki MH. Prevention and management of catheter-related infection in hemodialysis patients. Kidney Int. 2011; 79(6):587-598.
- Oliver MJ, Callery SM, Thorpe KE, Schwab SJ, Churchill DN. Risk of bacteremia from temporary hemodialysis catheters by site of insertion and duration of use: a prospective study.
Kidney Int. 2000;58(6):2543-2545.
- Stevenson KB, Hannah EL, Lowder CA, Adcox MJ, Davidson RL, Mallea MC, et al. Epidemiology of hemodialysis vascular access infections from longitudinal infection surveillance data. Am J Kidney Dis. 2002;39(3):549-55.
- Lee AY, Levine MN, Butler G, Webb C, Costantini L, Gu C, et al, Incidence, risk factors, and outcomes of catheter-related thrombosis in adult patients with cancer. J Clin Oncol. 2006;24(9):1404-8.