Natural saline-flush is sufficient to maintain patency of immobilized-urokinase double-lumen catheter used to provide temporary blood access for hemodialysis.
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.
Kaneko
Yoshikatsu
Y
Division of Clinical Nephrology and Rheumatology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan. kanekoy@mail.rockefeller.edu
Iwano
Masako
M
Yoshida
Hitomi
H
Kosuge
Miyoko
M
Ito
Sanae
S
Narita
Ichiei
I
Gejyo
Fumitake
F
Suzuki
Masashi
M
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*
D004800:Enzymes, Immobilized; D012965:Sodium Chloride; D006493:Heparin; D014568:Urokinase-Type Plasminogen Activator