Complications of Central Venous Catheter Insertion in Patients Undergoing Hemodialysis in Iran: A Systematic Review and Meta-analysis
International Journal of Medical Toxicology and Forensic Medicine,
Vol. 11 No. 1 (2021),
23 January 2021
Background: Regarding the prevalence of chronic renal disease and CVC (central venous catheterization) complications, this systematic review and meta-analysis was performed to determine the prevalence of CVC complications in Iran.
Methods: In this systematic review and meta-analysis, based on the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) protocol, all Iran and international databases from 2000 to 2019 were investigated using keywords of fever during or after dialysis, redness of the catheter insertion site, swelling, tenderness (touch sensitivity), infection, thrombosis, inadequate catheter (catheter malfunction), hemothorax, and pus outflow (pus drainage). The search was conducted by two members of the research team (MB, AT). In case of any disagreement between them, the quality of the investigation was examined by the third person (AB). In the present study, we analyzed data using comprehensive meta-analysis software.
Results: According to this study’s findings, 12 articles with a total sample of 1395 patients were included in the systematic review and meta-analysis. Our findings were as follows: the prevalence of hemodialysis infection was 26.6% (95%CI: 16.2%–40.6%) (I2=95.5, P<0.001, Q=236.66), the prevalence of thrombosis was 18.3% (95%CI: 11.2%-28.6%), and the prevalence of inadequate catheter (catheter malfunction) was 16.1% (95%CI: 9.2%-26.7%).
Conclusion: The prevalence of CVC complications was significant in hemodialysis patients. Therefore, appropriate interventions should be provided to reduce these complications.
- Hemodialysis, Complications, Central venous catheter, Iran.
How to Cite
Couser WG, Remuzzi G, Mendis S, Tonelli M. The contribution of chronic kidney disease to the global burden of major noncommunicable diseases. Kidney international. 2011;80(12):1258-70. [DOI:10.1038/ki.2011.368] [PMID]
Jha V, Garcia-Garcia G, Iseki K, Li Z, Naicker S, Plattner B, et al. Chronic kidney disease: global dimension and perspectives. The Lancet. 2013;382(9888):260-72. [DOI:10.1016/S0140-6736(13)60687-X]
Oshvandi K, Amini S, Moghimbeigi A, Sadeghian E. The effect of spiritual care on death anxiety in hemodialysis patients with end-stage of renal disease: A Randomized Clinical Trial. Journal of hayat. 2018;23(4):332-44.
Raiesifar A, Tayebi A, Mehrii SN, Ebadi A, Einollahi B, Tabibi H, et al. Effect of applying continuous care model on quality of life among kidney transplant patients: A randomized clinical trial. Iranian journal of kidney diseases. 2014;8(2):139.
Tayyebi A, Raiesifar A, Mehri SN, Ebadi A, Einolahi B, Pashandi S. Measuring health related quality of life (hrqol) in renal transplant patients: psychometric properties and cross-cultural adaptation of kidney transplant questionnaire (ktq-25) in persian. Nephro-urology monthly. 2012;4(4):617. [DOI:10.5812/numonthly.1382] [PMID] [PMCID]
Okhli A, Hojjati H, Sadeghloo A, Molaei A, Shahrabady SJJoR, Health. The Relationship Between Observing Religious Beliefs and Suffering in Hemodialysis Patients. 2019. [DOI:10.1007/s10943-019-00887-7] [PMID]
Tabiban S, Soleimani MA, Bakhshande H, Asghary M. Effect of an illness perception-based intervention on hemodialysis patients’ hope: A clinical trial study. Hayat. 2017;23(3):266-76.
Song Y-Y, Hu R-j, Diao Y-s, Chen L, Jiang X-L. Effects of exercise training on restless legs syndrome, depression, sleep quality, and fatigue among hemodialysis patients: a systematic review and meta-analysis. Journal of pain and symptom management. 2018;55(4):1184-95. [DOI:10.1016/j.jpainsymman.2017.12.472] [PMID]
Abdi A, Dalvand S, Vahedian-Azimi A, Ghanei Gheshlagh R, Kurdi A. Prevalence of depression among Iranian patients under hemodialysis; a systematic review and meta-analysis. Journal of Nephrology. 2018;7(4):224-32. [DOI:10.15171/jnp.2018.47]
Young HM, March DS, Graham-Brown MP, Jones AW, Curtis F, Grantham CS, et al. Effects of intradialytic cycling exercise on exercise capacity, quality of life, physical function and cardiovascular measures in adult haemodialysis patients: a systematic review and meta-analysis. Nephrology Dialysis Transplantation. 2018;33(8):1436-45. [DOI:10.1093/ndt/gfy045] [PMID]
Adwaney A, Lim C, Blakey S, Duncan N, Ashby DR. Central venous stenosis, access outcome and survival in patients undergoing maintenance hemodialysis. Clinical Journal of the American Society of Nephrology. 2019;14(3):378-84. [DOI:10.2215/CJN.07010618] [PMID] [PMCID]
Ko GJ, Rhee CM, Obi Y, Chang TI, Soohoo M, Kim TW, et al. Vascular access placement and mortality in elderly incident hemodialysis patients. Nephrology Dialysis Transplantation. 2018. [DOI:10.1093/ndt/gfy254] [PMID] [PMCID]
Hemmati, Dr Hossein, Safai Asal, Dr Afshin, Boye B, Dr Sazan, et al. Central venous catheter infections in hemodialysis patients. Journal of Guilan University of Medical Sciences. 2018; 27 (105): 20-7.v
Tavanaee Sani A, Nowkandeh E, Reza A, Ghorbany H. Central venous catheter related infection among patients on hemodialysis. medical journal of mashhad university of medical sciences. 2012;55(2):110-5.
Craswell A, Massey D, Wallis M, Sriram D, Gray NA, Kotwal S, et al. Current practice in dialysis central venous catheter management: Multi‐disciplinary renal team perspectives. Nephrology. 2019. [DOI:10.1111/nep.13626] [PMID]
Betjes MG. Prevention of catheter-related bloodstream infection in patients on hemodialysis. Nature Reviews Nephrology. 2011;7(5):257. [DOI:10.1038/nrneph.2011.28] [PMID]
Nelveg-Kristensen KE, Laier GH, Heaf JG. Risk of death after first-time blood stream infection in incident dialysis patients with specific consideration on vascular access and comorbidity. BMC infectious diseases. 2018;18(1):688. [DOI:10.1186/s12879-018-3594-7] [PMID] [PMCID]
Collins AJ, Foley RN, Gilbertson DT, Chen S-C. United States Renal Data System public health surveillance of chronic kidney disease and end-stage renal disease. Kidney international supplements. 2015;5(1):2-7. [DOI:10.1038/kisup.2015.2] [PMID] [PMCID]
Collins A, Foley R, Herzog C, Chavers B, Gilbertson D, Ishani A. Excerpts from the US Renal Data System 2009 Annual Data Report: Morbidity & Mortality. Am J Kidney Dis. 2010;55(1 Suppl 1):S1-S420. A6-7. [DOI:10.1053/j.ajkd.2009.10.009] [PMID] [PMCID]
Tabatabaie O, Kasumova GG, Kent TS, Eskander MF, Fadayomi AB, Ng SC, et al. Upper extremity deep venous thrombosis after port insertion: What are the risk factors? Surgery. 2017;162(2):437-44. [DOI:10.1016/j.surg.2017.02.020] [PMID]
Smitherman AB, Alexander T, Connelly M, Snavely AC, Weston BW, Liles EA, et al. The incidence of catheter-associated venous thrombosis in noncritically ill children. Hospital pediatrics. 2015;5(2):59-66. [DOI:10.1542/hpeds.2014-0041] [PMID]
Machat S, Eisenhuber E, Pfarl G, Stübler J, Koelblinger C, Zacherl J, et al. Complications of central venous port systems: a pictorial review. Insights into Imaging. 2019;10(1):86. [DOI:10.1186/s13244-019-0770-2] [PMID] [PMCID]
Tricco AC, Lillie E, Zarin W, O’Brien KK, Colquhoun H, Levac D, et al. PRISMA extension for scoping reviews (PRISMA-ScR): checklist and explanation. 2018;169(7):467-73. [DOI:10.7326/M18-0850] [PMID]
Afshar M, Savari F, Adib-Hajbaghery M, Gilasi H, Soleimani A, Baseri A, et al. Permanent hemodialysis catheter complications in patients referred to Kashan Akhavan dialysis center from June 2013 to December 2013. Feyz Journal of Kashan University of Medical Sciences. 2015;19.
GHANE SF. Comparison of the complications of central vein catheters and arterio-venous fistulae in children on chronic hemodialysis. 2006.
Adib-hajbagheri M, Molavizadeh N, Alavi NM, Abadi MHM. Factors associated with complications of vascular access site in hemodialysis patients in Isfahan Aliasghar hospital. Iranian Journal of Nursing and Midwifery Research. 2014;19(2):208.
Beigi AA, Ghaheri H, Jazi AHD, Alavi L. The Efficacy and Complications of Temporary and Permanent Central Venous Catheters in Patients with Renal Failure. Journal of Isfahan Medical School. 2012;29(163).
Samani S, Saffari M, Charkhchian M, Khaki A. Incidence and risk factors of bloodstream catheter-related infections in hemodialysis patients. Comparative Clinical Pathology. 2015;24(2):275-9. [DOI:10.1007/s00580-014-1890-1]
Sepas HN, Negahi A, Mousavie SH, Vosough F, Farazmand B. Patency and outcomes of tunneled hemodialysis catheter via femoral versus jugular vein access. Journal of Advanced Pharmaceutical Technology & Research. 2019;10(2):81. [DOI:10.4103/japtr.JAPTR_383_18] [PMID] [PMCID]
Soleymanian T, Sheikh V, Tareh F, Argani H, Ossareh S. Hemodialysis vascular access and clinical outcomes: an observational multicenter study. The journal of vascular access. 2017;18(1):35-42. [DOI:10.5301/jva.5000610] [PMID]
Sanavi S, Ghods A, Afshar R. Catheter associated infections in hemodialysis patients. Saudi journal of kidney diseases and transplantation. 2007;18(1):43.
Zafarghandi M-R, Nazari I, Taghavi M, Salimi J, Moini M, Askarpour S. Comparison of results of placement of cuffed-tunneled hemodialysis catheter in internal jugular vein with subclavian vein for long-term dialysis. Polish Journal of Surgery. 2013;85(3):133-6. [DOI:10.2478/pjs-2013-0023] [PMID]
Kazem Shahmoradi M, Khavaninzadeh M, Mousavi Kani K. Catheter related complications and survival among Iranian ESRD patients treated in Hasheminejad hospital; 2010-2011. Razi Journal of Medical Sciences. 2013;19(105).
Dreesen M, Foulon V, Spriet I, Goossens GA, Hiele M, De Pourcq L, et al. Epidemiology of catheter-related infections in adult patients receiving home parenteral nutrition: a systematic review. 2013;32(1):16-26. [DOI:10.1016/j.clnu.2012.08.004] [PMID]
Ramritu P, Halton K, Cook D, Whitby M, Graves NJJoan. Catheter‐related bloodstream infections in intensive care units: a systematic review with meta‐analysis. 2008;62(1):3-21. [DOI:10.1111/j.1365-2648.2007.04564.x] [PMID]
Zhang HH, Cortés-Penfield NW, Mandayam S, Niu J, Atmar RL, Wu E, et al. Dialysis Catheter-related Bloodstream Infections in Patients Receiving Hemodialysis on an Emergency-only Basis: A Retrospective Cohort Analysis. 2018;68(6):1011-6. [DOI:10.1093/cid/ciy555] [PMID] [PMCID]
Silva TN, de Marchi D, Mendes ML, Barretti P, Ponce DJHI. Approach to prophylactic measures for central venous catheter‐related infections in hemodialysis: A critical review. 2014;18(1):15-23. [DOI:10.1111/hdi.12071] [PMID]
Östlund Å, Fläring U, Norberg Å, Dahlberg A, Berner J, Kaiser S, et al. Incidence of and risk factors for venous thrombosis in children with percutaneous non-tunnelled central venous catheters. 2019. [DOI:10.1016/j.bja.2019.04.055] [PMID]
Hughes OU, Stella A, Samuel E. Complications of Internal jugular catheters in haemodialysis patients at a kidney care center in Nigeria. 2019. [DOI:10.29328/journal.jcn.1001037]
- Abstract Viewed: 29 times