Longer duration of catheter patency, but similar infection rates with internal jugular vein versus iliac vein tunneled cuffed hemodialysis catheters: a single-center retrospective analysis.
BACKGROUND
Although tunneled cuffed catheters (TCCs) are widely used in hemodialysis, little is known about their complications in elderly patients with hemodialysis. Furthermore, there is no report about which vessel access, either jugular or iliac vein, is superior for elderly patients requiring TCCs.


METHODS
In the present study, we reviewed the clinical parameters of 127 patients aged over 65 years with 207 new TCC placements and measured the incidence of catheter patency, infection, dysfunction, and survival of TCCs.


RESULTS
We found that the average primary catheter patency was substantially shorter in iliac vein TCCs than in internal jugular vein TCCs (373 vs. 641 catheter-days). Patients with iliac vein TCCs underwent more frequent exchanges than those with internal jugular vein TCCs. Infection-free survival was similar for both groups (p = 0.748), but dysfunction-free survival was significantly poorer in iliac vein TCC group than that in internal jugular vein TCC group (p = 0.001). Age and previous catheter placement were the independent risk factors for TCCs survival.


CONCLUSIONS
Taken together, our results suggested that iliac vein TCCs present an increased risk of dysfunction compared to internal jugular vein TCCs in elderly hemodialysis patients.
Department of Kidney Disease and Blood Purification Center, Institute of Urology and Key Laboratory of Tianjin, 2nd Affiliated Hospital of Tianjin Medical University, 23rd, Pingjiang Road, Hexi District, Tianjin, 300211, People's Republic of China.
Lihua
L
Wang
Department of Kidney Disease and Blood Purification Center, Institute of Urology and Key Laboratory of Tianjin, 2nd Affiliated Hospital of Tianjin Medical University, 23rd, Pingjiang Road, Hexi District, Tianjin, 300211, People's Republic of China.
Fang
F
Wei
Department of Kidney Disease and Blood Purification Center, Institute of Urology and Key Laboratory of Tianjin, 2nd Affiliated Hospital of Tianjin Medical University, 23rd, Pingjiang Road, Hexi District, Tianjin, 300211, People's Republic of China. ailiJiang2014@yeah.net.
Aili
A
Jiang
Department of Kidney Disease and Blood Purification Center, Institute of Urology and Key Laboratory of Tianjin, 2nd Affiliated Hospital of Tianjin Medical University, 23rd, Pingjiang Road, Hexi District, Tianjin, 300211, People's Republic of China.
Haiyan
H
Chen
Department of Kidney Disease and Blood Purification Center, Institute of Urology and Key Laboratory of Tianjin, 2nd Affiliated Hospital of Tianjin Medical University, 23rd, Pingjiang Road, Hexi District, Tianjin, 300211, People's Republic of China.
Guijiang
G
Sun
Department of Kidney Disease and Blood Purification Center, Institute of Urology and Key Laboratory of Tianjin, 2nd Affiliated Hospital of Tianjin Medical University, 23rd, Pingjiang Road, Hexi District, Tianjin, 300211, People's Republic of China.
Xueqing
X
Bi
D000368:Aged; D016470:Bacteremia / Q000209:etiology; D061807:Catheter Obstruction; D055499:Catheter-Related Infections / Q000209:etiology*; D002405:Catheterization, Central Venous / Q000009:adverse effects* / Q000295:instrumentation; D002408:Catheters, Indwelling / Q000009:adverse effects*; D062905:Central Venous Catheters / Q000009:adverse effects*; D005260:Female; D006801:Humans; D007084:Iliac Vein; D007601:Jugular Veins; D053208:Kaplan-Meier Estimate; D007676:Kidney Failure, Chronic / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D011475:Prosthesis Failure; D006435:Renal Dialysis / Q000009:adverse effects; D012189:Retrospective Studies; D013997:Time Factors
Elderly patients; Hemodialysis; Iliac vein TCCs; Internal jugular vein TCCs; Tunneled cuffed catheters