[Permanent catheters for hemodialysis: indications, methods and results. French national survey 1998-2000].
A national survey on permanent hemodialysis catheters was conducted in 99 hemodialysis centers between january 1998 and january 2000. It was a prospective, national and multicentric study. Data were gathered in 1552 patients (mean age 65 +/- 15 years) with chronic end stage renal failure. A questionnaire was filled out each time a permanent hemodialysis catheter was inserted. Two permanent catheters (72%) were inserted under local anesthesia (92%), using the right internal jugular vein (81%) with a percutaneous technique (96%). The two main indications were: end stage chronic renal failure without creation of a vascular access (52%) and dysfunction of a preexisting vascular access (35%). Patients have been followed a mean time period of 58 days and 179 cases of death have been reported. The median duration of catheters was 500 days. The two main causes of catheter removal were creation of a functional A-V fistula (40%) and death of the patient (28%). The incidence of bacteriemia/septicemia was 0.74 episode/patient/1000 days of follow-up while that of any type of infection was 0.85 episode/patient/1000 days. The risk of infection increased with time especially in type 2 diabetes patients.
Legendre
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Service de néphrologie, Hôpital Saint-Louis, Paris.
Canaud
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D000368:Aged; D000772:Anesthesia, Local; D016470:Bacteremia / Q000453:epidemiology; D002404:Catheterization / Q000009:adverse effects / Q000379:methods*; D002408:Catheters, Indwelling / Q000009:adverse effects; D005602:France; D006801:Humans; D007239:Infections / Q000453:epidemiology; D007601:Jugular Veins; D007676:Kidney Failure, Chronic / Q000401:mortality / Q000628:therapy*; D008875:Middle Aged; D011446:Prospective Studies; D006435:Renal Dialysis; D018805:Sepsis / Q000453:epidemiology; D011795:Surveys and Questionnaires; D013997:Time Factors