title: Patency and Complications of Translumbar Dialysis Catheters.
abstract: Translumbar tunneled dialysis catheter (TLDC) is a temporary dialysis access for patients exhausted traditional access for dialysis. While few small studies reported successes with TLDC, additional studies are warranted to understand the short- and long-term patency and safety of TLDC. We conducted a retrospective analysis of adult patients who received TLDC for hemodialysis access from June 2006 to June 2013. Patient demographics, comorbid conditions, dialysis details, catheter insertion procedures and associated complications, catheter patency, and patient survival data were collected. Catheter patency was studied using Kaplan-Meier curve; catheter functionality was assessed with catheter intervals and catheter-related complications were used to estimate catheter safety. There were 84 TLDCs inserted in 28 patients with 28 primary insertions and 56 exchanges. All TLDC insertions were technically successful with good blood flow during dialysis (>300 ml/minute) and no immediate complications (major bleeding or clotting) were noted. The median number of days in place for initial catheter, secondary catheter, and total catheter were 65, 84, and 244 respectively. The catheter patency rate at 3, 6, and 12 months were 43%, 25%, and 7% respectively. The main complications were poor blood flow (40%) and catheter-related infection (36%), which led to 30.8% and 35.9% catheter removal, respectively. After translumbar catheter, 42.8% of the patients were successfully converted to another vascular access or peritoneal dialysis. This study data suggest that TLDC might serve as a safe, alternate access for dialysis patients in short-term who have exhausted conventional vascular access.
authors: Department of Nephrology and Hypertension, Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, Ohio.|Department of Nephrology, the First Affiliated Hospital of Jinan University, Guangzhou, China.
authors: Fanna
authors: F
authors: Liu
authors: Imaging Institute, Cleveland Clinic, Cleveland, Ohio.
authors: Stacy
authors: S
authors: Bennett
authors: Department of Quantitative Health Sciences, Cleveland Clinic, Cleveland, Ohio.
authors: Susana
authors: S
authors: Arrigain
authors: Department of Quantitative Health Sciences, Cleveland Clinic, Cleveland, Ohio.
authors: Jesse
authors: J
authors: Schold
authors: Department of Nephrology and Hypertension, Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, Ohio.
authors: Robert
authors: R
authors: Heyka
authors: Imaging Institute, Cleveland Clinic, Cleveland, Ohio.
authors: Gordon
authors: G
authors: McLennan
authors: Department of Nephrology and Hypertension, Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, Ohio.|Cleveland Clinic Lerner College of Medicine of CWRU, Cleveland, Ohio.
authors: Sankar D
authors: SD
authors: Navaneethan
mesh_terms: D057785:Catheters / Q000009:adverse effects*; D004868:Equipment Failure; D005260:Female; D006801:Humans; D008161:Lumbosacral Region; D008297:Male; D008875:Middle Aged; D006435:Renal Dialysis / Q000295:instrumentation*; D012189:Retrospective Studies