title: A retrospective study of palindrome symmetrical-tip catheters for chronic hemodialysis access in China.
abstract: Hemodialysis catheters remain necessary for long-term vascular access in patients for whom arteriovenous access may be problematic or impossible. Developments in catheter design have improved long-term catheter functionality, and reduced the rate of infection and complications associated with their use. This retrospective study of 284 cases of chronic catheterization in 271 patients treated between 2009 and 2011 using Tal Palindrome™ symmetrical-tip (N = 118) or Quinton™ Permcath™ step-tip (N = 166) hemodialysis catheters evaluates the efficacy and the safety of symmetrical-tip dialysis catheters for chronic hemodialysis, compared with a step-tip catheter. Measurements of catheter performance included mean catheter dwell time, incidence of low blood flow, and rates of infection and catheter-related blood stream infection (CRBSI). The symmetrical-tip catheter had a significantly longer mean dwell time compared with the step-tip catheter; 329.4 ± 38.1 versus 273.1 ± 25.4 d (p < 0.05). In addition, the rate of occurrence of low blood flow per 1000 catheter days was lower for the symmetrical-tip compared with the step-tip catheter; 1.13 versus 6.86 (p < 0.01). The symmetrical-tip catheter was also associated with a lower incidence of complications; the rates of infection (0.28 vs. 0.78; p < 0.01) and CRBSI (0.15 vs. 0.44; p < 0.01) were lower compared with those for step-tip catheters, and catheter removal occurred less often for the symmetrical-tip catheter (8% vs. 16%; p < 0.05). The symmetrical-tip hemodialysis catheter was associated with a longer mean dwell time, lower incidence of low blood flow, and lower infection rate compared with the step-tip catheter.
authors.affiliation: a Department of Nephrology , Changzheng Hospital, Second Military Medical University, Research Institute of Nephrology , PLA , Shanghai , China.
authors.forename: Chaoyang
authors.initials: C
authors.lastname: Ye
authors.affiliation: a Department of Nephrology , Changzheng Hospital, Second Military Medical University, Research Institute of Nephrology , PLA , Shanghai , China.
authors.forename: Zhiguo
authors.initials: Z
authors.lastname: Mao
authors.affiliation: a Department of Nephrology , Changzheng Hospital, Second Military Medical University, Research Institute of Nephrology , PLA , Shanghai , China.
authors.forename: Pan
authors.initials: P
authors.lastname: Zhang
authors.affiliation: a Department of Nephrology , Changzheng Hospital, Second Military Medical University, Research Institute of Nephrology , PLA , Shanghai , China.
authors.forename: Yuqiang
authors.initials: Y
authors.lastname: Zhang
authors.affiliation: a Department of Nephrology , Changzheng Hospital, Second Military Medical University, Research Institute of Nephrology , PLA , Shanghai , China.
authors.forename: Shu
authors.initials: S
authors.lastname: Rong
authors.affiliation: a Department of Nephrology , Changzheng Hospital, Second Military Medical University, Research Institute of Nephrology , PLA , Shanghai , China.
authors.forename: Jing
authors.initials: J
authors.lastname: Chen
authors.affiliation: a Department of Nephrology , Changzheng Hospital, Second Military Medical University, Research Institute of Nephrology , PLA , Shanghai , China.
authors.forename: Changlin
authors.initials: C
authors.lastname: Mei
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D055499:Catheter-Related Infections / Q000453:epidemiology* / Q000503:physiopathology; D002408:Catheters, Indwelling; D016009:Chi-Square Distribution; D002681:China; D015331:Cohort Studies; D020878:Device Removal; D004867:Equipment Design; D004868:Equipment Failure; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000175:diagnosis / Q000401:mortality / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D006435:Renal Dialysis / Q000295:instrumentation* / Q000379:methods / Q000401:mortality; D012189:Retrospective Studies; D018570:Risk Assessment; D016019:Survival Analysis; D013997:Time Factors; D016896:Treatment Outcome
keywords: Catheters; catheter-related infections; renal dialysis; retrospective studies; vascular access devices