title: Epidemiology of haemodialysis catheter complications: a survey of 865 dialysis patients from 14 haemodialysis centres in Henan province in China.
abstract: OBJECTIVE
  To investigate the incidence rates and risk factors for catheter-related complications in different districts and populations in Henan Province in China.
  
  
  METHODS
  Cross-sectional.
  
  
  METHODS
  Fourteen hospitals in Henan Province.
  
  
  METHODS
  865 patients with renal dysfunction undergoing dialysis using catheters between October 2013 and October 2014.
  
  
  METHODS
  The main outcome measures were complications, risk factors and patient characteristics. Catheter-related complications included catheter-related infection (catheter exit-site infection, catheter tunnel infection and catheter-related bloodstream infection), catheter dysfunction (thrombosis, catheter malposition or kinking, and fibrin shell formation) and central vein stenosis.
  
  
  RESULTS
  The overall incidence rate was 7.74/1000 catheter-days, affecting 38.61% of all patients, for catheter infections, 10.58/1000 catheter-days, affecting 56.65% of all patients, for catheter dysfunction, and 0.68/1000 catheter-days, affecting 8.79% of all patients, for central vein stenosis. Multivariate analysis showed that increased age, diabetes, primary educational level or below, rural residence, lack of a nephropathy visit before dialysis and pre-established permanent vascular access, not taking oral drugs to prevent catheter thrombus, lower serum albumin levels and higher ferritin levels were independently associated with catheter infections. Rural residence, not taking oral drugs to prevent thrombus, lack of an imaging examination after catheter insertion, non-tunnel catheter type, lack of medical insurance, lack of nephropathy visit before dialysis and pre-established permanent vascular access, left-sided catheter position, access via the femoral vein and lower haemoglobin level were independently associated with catheter dysfunction. Diabetes, lack of nephropathy visit before dialysis and pre-established permanent vascular access, lack of oral drugs to prevent catheter thrombus, left-sided catheter location and higher number of catheter insertions, were independently associated with central vein stenosis.
  
  
  CONCLUSIONS
  The rate of catheter-related complications was high in patients with end-stage renal disease in Henan Province. Our finding suggest that strategies should be implemented to decrease complication rates.
authors.affiliation: Department of Blood Purification, The First Affiliated Hospital, Zhengzhou University, Institute of Nephrology, Zhengzhou University, Zhengzhou, Henan Province, China.
authors.forename: Kai
authors.initials: K
authors.lastname: Wang
authors.affiliation: Department of Blood Purification, The First Affiliated Hospital, Zhengzhou University, Institute of Nephrology, Zhengzhou University, Zhengzhou, Henan Province, China.
authors.forename: Pei
authors.initials: P
authors.lastname: Wang
authors.affiliation: Department of Blood Purification, The First Affiliated Hospital, Zhengzhou University, Institute of Nephrology, Zhengzhou University, Zhengzhou, Henan Province, China.
authors.forename: Xianhui
authors.initials: X
authors.lastname: Liang
authors.affiliation: Department of Blood Purification, The First Affiliated Hospital, Zhengzhou University, Institute of Nephrology, Zhengzhou University, Zhengzhou, Henan Province, China.
authors.forename: Xiaoqing
authors.initials: X
authors.lastname: Lu
authors.affiliation: Department of Blood Purification, The First Affiliated Hospital, Zhengzhou University, Institute of Nephrology, Zhengzhou University, Zhengzhou, Henan Province, China.
authors.forename: Zhangsuo
authors.initials: Z
authors.lastname: Liu
mesh_terms: D000293:Adolescent; D000328:Adult; D055499:Catheter-Related Infections / Q000453:epidemiology*; D002404:Catheterization; D002405:Catheterization, Central Venous / Q000009:adverse effects*; D002681:China; D003251:Constriction, Pathologic / Q000453:epidemiology*; D003430:Cross-Sectional Studies; D004867:Equipment Design; D004868:Equipment Failure; D005260:Female; D006801:Humans; D015994:Incidence; D007676:Kidney Failure, Chronic / Q000628:therapy; D008297:Male; D008875:Middle Aged; D006435:Renal Dialysis / Q000009:adverse effects* / Q000295:instrumentation / Q000379:methods; D012307:Risk Factors; D013927:Thrombosis / Q000453:epidemiology*; D014680:Veins / Q000473:pathology*; D055815:Young Adult