Comparison of heparin-coated and conventional split-tip hemodialysis catheters.
Catheter coatings have the potential to decrease infection and thrombosis in patients with chronic dialysis catheters. We report our midterm experience with a heparin-coated dialysis catheter. This retrospective, case-control study was approved by our Institutional Review Board. A total of 88 tunneled dialysis catheters were inserted over a 13-month period via the internal jugular vein. Thirty-eight uncoated split-tip catheters and 50 heparin-coated catheters were inserted. Primary catheter patency was compared between the two groups using the log rank test, with infection and/or thrombosis considered as catheter failures. Dialysis parameters during the first and last dialysis sessions, including pump speed, actual blood flow, and arterial port pressures, were compared using unpaired t-tests. Primary patency of the uncoated catheters was 86.0 +/- 6.5% at 30 days and 76.1 +/- 8.9% at 90 days. Primary patency of heparin-coated catheters was 92.0 +/- 6.2% at 30 days and 81.6 +/- 8.0% at 90 days (p = 0.87, log rank test). Infection requiring catheter removal occurred in four patients with uncoated catheters and two patients with heparin-coated catheters (p = 0.23). Catheter thrombosis requiring catheter replacement or thrombolysis occurred in one patient with an uncoated catheter and two patients with heparin-coated catheters (p = 0.9). No differences in catheter function during hemodialysis were seen between the two groups. In conclusion, the heparin-coated catheter did not show a significantly longer patency compared to the uncoated catheter. The flow characteristics of this device were comparable to those of the conventional uncoated catheter. A demonstrable benefit of the heparin-coated catheter in randomized trials is needed before a recommendation for routine implementation can be made.
Clark
Timothy W I
TW
Section of Vascular and Interventional Radiology, Department of Radiology, New York University School of Medicine, 560 First Avenue, HE-221, New York, NY 10016, USA. timothy.clark@nyumc.org
Jacobs
David
D
Charles
Hearns W
HW
Kovacs
Sandor
S
Aquino
Theresa
T
Erinjeri
Joseph
J
Benstein
Judith A
JA
D016022:Case-Control Studies; D002405:Catheterization, Central Venous / Q000295:instrumentation*; D020099:Coated Materials, Biocompatible; D005260:Female; D006493:Heparin; D006801:Humans; D007601:Jugular Veins; D008297:Male; D015641:Radiography, Interventional; D006435:Renal Dialysis / Q000295:instrumentation*; D012189:Retrospective Studies; D016896:Treatment Outcome; D018084:Ultrasonography, Interventional; D014654:Vascular Patency
D020099:Coated Materials, Biocompatible; D006493:Heparin