title: Natural saline-flush is sufficient to maintain patency of immobilized-urokinase double-lumen catheter used to provide temporary blood access for hemodialysis.
abstract: BACKGROUND
  Thrombotic occlusion is a frequent complication of central venous catheters used to provide temporary blood access on hemodialysis therapy. Heparin-lock is conventionally used to maintain patency of the catheter, but the necessity of heparin-lock has not been determined yet.
  
  
  METHODS
  After the immobilized-urokinase double-lumen central venous catheter was inserted into 48 Japanese hemodialysis patients, 22 patients randomized to the heparin group received a 20-ml saline-flush, followed by 2 ml of 1,000 U/ml heparin-lock, and 26 patients randomized to the saline group received only the 20-ml saline-flush once a day for each lumen.
  
  
  RESULTS
  Thrombotic occlusion was observed in only 1 out of 22 patients in the heparin group and 1 out of 26 patients in the saline group. No significant difference of the catheter survival was observed between the two groups (p = 0.8599).
  
  
  CONCLUSIONS
  Natural saline-flush is sufficient for maintaining the patency of an immobilized-urokinase double-lumen central venous catheter.
authors.affiliation: Division of Clinical Nephrology and Rheumatology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan. kanekoy@mail.rockefeller.edu
authors.forename: Yoshikatsu
authors.initials: Y
authors.lastname: Kaneko
authors.forename: Masako
authors.initials: M
authors.lastname: Iwano
authors.forename: Hitomi
authors.initials: H
authors.lastname: Yoshida
authors.forename: Miyoko
authors.initials: M
authors.lastname: Kosuge
authors.forename: Sanae
authors.initials: S
authors.lastname: Ito
authors.forename: Ichiei
authors.initials: I
authors.lastname: Narita
authors.forename: Fumitake
authors.initials: F
authors.lastname: Gejyo
authors.forename: Masashi
authors.initials: M
authors.lastname: Suzuki
mesh_terms: D000368:Aged; D001777:Blood Coagulation / Q000187:drug effects; D002404:Catheterization / Q000592:standards*; D004800:Enzymes, Immobilized; D004868:Equipment Failure; D005260:Female; D006493:Heparin / Q000627:therapeutic use; D006801:Humans; D007676:Kidney Failure, Chronic / Q000628:therapy; D008297:Male; D008875:Middle Aged; D006435:Renal Dialysis / Q000295:instrumentation* / Q000379:methods; D012965:Sodium Chloride / Q000494:pharmacology*; D016896:Treatment Outcome; D014568:Urokinase-Type Plasminogen Activator / Q000627:therapeutic use*
chemical_list: D004800:Enzymes, Immobilized; D012965:Sodium Chloride; D006493:Heparin; D014568:Urokinase-Type Plasminogen Activator