Patency and complications of patients with tunneled dialysis catheters: A long-term follow-up study

Abstract

Objectives: This study aims to report long-term follow-up results including catheter patency and catheter dysfunction in patients withtunneled dialysis catheters (TDCs) during the treatment phase.Patients and methods: Medical records of a total of 90 patients (54 males, 36 females; mean age 59.9±19 years; range, 19 to 89 years) with acombined total of 103 TDCs inserted by a single cardiovascular surgeon at our institution between January 2014 and December 2017 werereviewed retrospectively. Data including age, gender, duration of hospital stay, catheter patency, complications, and mortality were recorded.The patients were divided into two groups according to age: <60 years (n=41) and ?60 years (n=49).Results: Technical success was achieved without any procedural complications and hemodialysis was initiated following the catheterplacement in all patients. The mean duration of catheter use was 729.6±58.4 (range, 20 to 1,100) days. Of all patients, 18 (20%) died withinone year following the procedure. A total of 28 TDCs (24.77%) were electively removed, as these patients gained other types of permanentaccess. One of them underwent a kidney transplant. Catheter-related complications were observed in 24 patients (21.23%) and TDCs of13 patients were replaced. Twelve complications (10.61%) were related to catheter dysfunction, and the remaining 12 were due to catheterrelatedinfections (CRIs). Ten of the patients with CRIs were treated successfully, while the remaining two died. No significant correlationwas found between the catheter patency, catheter-related complications, and baseline characteristics of the patients, except for age. Youngerage was a predictor of poor catheter patency (p=0.040). Fifty six patients (62%) who were discharged on the day of their catheter placementhad significantly fewer complications than the hospitalized patients (p=0.011).Conclusion: The prevention of TDC-related complications requires a careful insertion technique and extensive surgical experience. TheTDC patency and reducing the number of complications are also closely associated with early discharge and the age of patient.