title: A single institutional experience of conversion of non-tunneled to tunneled hemodialysis catheters: a comparison to de novo placement.
abstract: OBJECTIVE
  To compare the outcomes of conversion of non-tunneled to tunneled hemodialysis catheters with de novo placement of tunneled catheters and to determine the effect of time to conversion of non-tunneled to tunneled catheters on the incidence of complications.
  
  
  METHODS
  A retrospective data analyses was performed on 1,154 patients who had de novo placement of tunneled hemodialysis catheters (control group) and 254 patients who underwent conversion of non-tunneled to tunneled catheters (study group). The outcomes including technical complications, infection, and catheter dysfunction were compared between the two groups.
  
  
  RESULTS
  The technical success rate was 100 % in both the groups with no complications recorded at the time of procedure or within 24 h of insertion. The most common complication encountered in both the groups was catheter dysfunction (15.6 % in controls and 18.1 % in study). Infection rates/100 catheter days for the control and study groups were 0.17 and 0.19, respectively. Infection-free survival was not statistically different between the two groups. The time spent with non-tunneled catheter prior to conversion did not significantly alter the rates of catheter dysfunction and infection in the study group.
  
  
  CONCLUSIONS
  The efficacy and safety of conversion of non-tunneled to tunneled hemodialysis catheters are similar to de novo placement with no difference in the rates of technical success, catheter dysfunction, or infection. However, the exchange of non-tunneled to tunneled catheter can help in preservation of veins for future vascular access, which is of vital importance in patients with chronic renal disease.
authors.affiliation: Department of Interventional Radiology, William Beaumont Hospital, 3601, W 13 Mile Road, Royal Oak, MI, 48073, USA, bajaj_sunil2001@yahoo.com.
authors.forename: Sunil Kumar
authors.initials: SK
authors.lastname: Bajaj
authors.forename: Joseph
authors.initials: J
authors.lastname: Ciacci
authors.forename: Matthias
authors.initials: M
authors.lastname: Kirsch
authors.forename: John D
authors.initials: JD
authors.lastname: Ebersole
mesh_terms: D000368:Aged; D016470:Bacteremia / Q000209:etiology; D055499:Catheter-Related Infections / Q000209:etiology*; D002406:Catheterization, Peripheral / Q000009:adverse effects / Q000295:instrumentation* / Q000379:methods; D002408:Catheters, Indwelling / Q000009:adverse effects*; D020878:Device Removal; D004868:Equipment Failure; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D053208:Kaplan-Meier Estimate; D007676:Kidney Failure, Chronic / Q000628:therapy; D008297:Male; D008875:Middle Aged; D006435:Renal Dialysis / Q000295:instrumentation* / Q000379:methods; D012189:Retrospective Studies; D013997:Time Factors