[Outcome of tunneled hemodialysis catheters as permanent vascular access].
Tunneled cuffed hemodialysis catheters (THC) are developed as a means of short hemodialysis access while a more permanent form of access are maturing. The aim of this study is to investigate the effectiveness, survival and complications of the THC used for long-term vascular access.


METHODS
In a retrospective study we looked at 42 THC inserted between November 2000 and October 2003, in 40 elderly patients, with systemic disease or when other vascular access was not possible.


RESULTS
Procedural complications occurred in 5 cases (11.9%), which included: local haemorrhage (3), hemothorax (1) and one fatal venous tear. 6 catheters (14.2%) were removed due to complications (non-function 3 and bacteraemia 3). The total incidence of THC related infections was 0.18 episodes/1,000 catheters-days. Patients were followed up for a mean 379 days (range 1-1,140) and a total of 15,946 catheter-days. Qb and KT/V achieved at one month were 278.3 +/- 34.1 ml/min and 1.48 +/- 0.27 respectively. At the end of the follow-up, 23 patients (54.7%) were alive with catheter functioning. One, three and twelve months survival was 90.4%, 73.1% and 59.5% respectively.


CONCLUSIONS
The THC may be a useful alternative permanent vascular access for hemodialysis patients when others vascular access are not possible.
Hernández-Jaras
J
J
Servicio de Nefrología, Hospital General de Castellón, Centro de Diálisis Gambro HealthCare. hernandez_jul@gva.es
García-Pérez
H
H
Torregrosa
E
E
Pons
R
R
Calvo
C
C
Serra
M
M
Orts
M
M
Ríus
A
A
Camacho
G
G
Bernat
A
A
Sánchez-Canel
J J
JJ
D000368:Aged; D000369:Aged, 80 and over; D002405:Catheterization, Central Venous / Q000009:adverse effects* / Q000379:methods*; D002408:Catheters, Indwelling / Q000009:adverse effects*; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D006435:Renal Dialysis / Q000379:methods*; D012189:Retrospective Studies; D016896:Treatment Outcome