Survival and Clinical Outcomes of Tunneled Central Jugular and Femoral Catheters in Prevalent Hemodialysis Patients

Background: The literature on the outcomes of tunneled femoral catheters compared to that of jugular catheters is scarce and derived mainly from small cohorts. Material and Methods: Seven hundred and sixty six catheters were placed in 673 hemodialysis patients, 622 in the jugular/subclavian veins and 144 in the femoral veins. Patients were followed prospectively for 36 months. Results: The survival of the tunneled catheters was 771 days 95% CI (737–805) for jugular and 660 days 95% CI (582–739) for femoral veins. Blood flow (0.292 ± 0.003 L/min) and infection rate (0.25 × 1,000 days/catheter) were similar for upper and lower extremities vascular accesses. Factors including sex, age, diabetes and previous catheters did not affect the outcome. Conclusions: Femoral catheters provide outstanding vascular access with excellent, function and low risk of infection.

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Skin Blood Flow in the Upper and Lower Extremities of Diabetic Patients with and without Autonomic Neuropathy

Journal of Vascular Research ◽

10.1159/000081810 ◽

2004 ◽

Vol 41 (6) ◽

pp. 535-545 ◽

Cited By ~ 44

Author(s):

V. Urbancic-Rovan ◽

A. Stefanovska ◽

A. Bernjak ◽

K. Ažman-Juvan ◽

A. Kocijančič

Keyword(s):

Blood Flow ◽

Autonomic Neuropathy ◽

Skin Blood Flow ◽

Lower Extremities ◽

Diabetic Patients ◽

Upper And Lower Extremities

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Clinical utility of far-infrared therapy for improvement of vascular access blood flow and pain control in hemodialysis patients

Kidney Research and Clinical Practice ◽

10.1016/j.krcp.2015.12.001 ◽

2016 ◽

Vol 35 (1) ◽

pp. 35-41 ◽

Cited By ~ 5

Author(s):

Soo Jeong Choi ◽

Eun Hee Cho ◽

Hye Min Jo ◽

Changwook Min ◽

Young Sok Ji ◽

...

Keyword(s):

Blood Flow ◽

Vascular Access ◽

Pain Control ◽

Clinical Utility ◽

Far Infrared ◽

Hemodialysis Patients

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Vascular Access Blood Flow Estimation Based On Standardized Extracorporeal Blood Flow in Hemodialysis Patients

10.21203/rs.3.rs-970936/v1 ◽

2021 ◽

Author(s):

Franklin Geovany Mora-Bravo ◽

Sonia Catalina Rivera González ◽

Pamela Tatiana Morales Torres ◽

Marco Rivera Ullauri

Keyword(s):

Blood Flow ◽

Observational Study ◽

Upper Limb ◽

Vascular Access ◽

Hemodialysis Patients ◽

Arterial Line ◽

Flow Estimation ◽

Extracorporeal Blood ◽

Hemodialysis Unit ◽

The Right

Abstract Background: Measurement of vascular access flow (Qa) is a recommendation in the care of hemodialysis patients. We developed an observational study to answer the following question: Can access blood flow be estimated?Methods: This observational study was carried out in the hemodialysis unit of the José Carrasco Arteaga Hospital in Cuenca-Ecuador. The sample calculation was 41 cases. Patients older than 17 years with stage 5d chronic renal failure and vascular access with arteriovenous fistula were included. The variables were descriptive of the population: Qa and extracorporeal blood flow (Qb). Qa measurement was performed with the Transonic ® monitor. Qb was measured at dynamic arterial line pressures (DALPs) of -60 mmHg, -100 mmHg, -160 mmHg, and -200 mmHg. The correlation coefficient "r" was obtained between Qa and Qb. SPSS 22.0 was used to analyze the information and perform a linear regression equation to estimate access blood flow (eQa).Results: Fifty-seven patients aged 62.9 ± 12.7 years with 29.4 ± 33 months on hemodialysis were included; 23 women (40.3%) and 45.6% had diabetic nephropathy. Fistulas were seen in 40 cases in the left upper limb (70.2%) and 17 (29.8%) in the right upper limb. The prevalence of aneurysms was 10.5%. The 50th percentile of Qb was 415 mL/min with a DALP of -200 mmHg. The mean access flow was 1516 ± 878 ml/min. The correlation between Qb and Qa was statistically more significant between Qb and DALP of -200 mmHg. The association had a coefficient Rs = 0.643 (IC 0.453 to 0.771) P <0.0001. The estimated access flow eQa = (Qb at DALP of -200 mmHg (mL/min) * 16.63) - 5449.71.Conclusions: It was possible to estimate access blood flow with parameters for easy intradialysis measurements. The equation obtained, if applied to the same patient with the same DALP, could become a useful parameter for monitoring vascular access.Trial registration: ClinicalTrials.gov Identifier: NCT00522704. Registered 14 March 2008, https://clinicaltrials.gov/ct2/show/NCT00522704

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Association of Clinic Vascular Access Monitoring Practices with Clinical Outcomes in Hemodialysis Patients

Nephron Clinical Practice ◽

10.1159/000094961 ◽

2006 ◽

Vol 104 (4) ◽

pp. c151-c159 ◽

Cited By ~ 8

Author(s):

Laura C. Plantinga ◽

Bernard G. Jaar ◽

Brad Astor ◽

Nancy E. Fink ◽

Joseph A. Eustace ◽

...

Keyword(s):

Clinical Outcomes ◽

Vascular Access ◽

Hemodialysis Patients

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A Simple and Cheap Hospitalization Risk Assessment Tool for Use in Hemodialysis Patients

Blood Purification ◽

10.1159/000490544 ◽

2018 ◽

Vol 46 (4) ◽

pp. 265-268

Author(s):

Muhammad Nauman Hashmi ◽

Hammad Raza ◽

Wael Elshazly ◽

Fayez Hejaili ◽

Abdullah Al Sayyari

Keyword(s):

Diabetes Mellitus ◽

High Risk ◽

Vascular Access ◽

Assessment Tool ◽

Risk Group ◽

Hemodialysis Patients ◽

High Risk Group ◽

Low Risk ◽

Group Score ◽

Hospitalization Rates

Objective: To develop a simple, objective, cheap scoring tool incorporating nutritional parameters and other variables to predict hospitalization and mortality among hemodialysis patients – a tool that could be utilized in low resource countries. Methods: The following variables were scored according to severity into 0, 1, 2 or 3: BMI, functional capacity, HD vintage in years, serum albumin, serum ferritin, and the number of comorbid conditions (diabetes mellitus, hypertension, ischemic heart disease, cerebrovascular disease). This tool was evaluated on our regular hemodialysis patients who were followed up for 24 months (June 2015 till July 2017). In our study population, the maximum score recorded was 12; accordingly, a score of 6 was used to differentiate between a low-risk group (score < 6) or a high-risk group (score ≥6). The 2 groups were compared (using the Chi square test) for possible differences in mortality and hospitalization rates during the follow-up period. Results: One hundred and forty adult hemodialysis patients were monitored over 2 years; 83 were males and 57 females; 59% of the patients had diabetes mellitus. Twenty-nine patients (30.7%) were found to be in the high-risk group and 111 (79.3%) in the low-risk group. The high-risk patients were almost one and a half times more likely to be hospitalized for vascular access issues than the low-risk group (p = 0.056) and 3 times more likely to be hospitalized for non-vascular access issues than the low-risk group (p = 0.0001). The mortality rate in the high-risk group was 3.1 times that in the low-risk group, but this was not statistically significant. Conclusion: Using a simple and cheap assessment tool in hemodialysis patients, we have identified patients at high risk for hospitalization rates and mortality. Video Journal Club “Cappuccino with Claudio Ronco” at http://www.karger.com/?doi=490544.

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Cuffed-tunneled Femoral Catheter for Long-term Hemodialysis

The International Journal of Artificial Organs ◽

10.1177/039139880102400702 ◽

2001 ◽

Vol 24 (7) ◽

pp. 443-446 ◽

Cited By ~ 15

Author(s):

K.M. Chow ◽

C.C. Szeto ◽

C.B. Leung ◽

T. Y.H. Wong ◽

P.K.T. Li

Keyword(s):

Blood Flow ◽

Blood Flow Rate ◽

Hemodialysis Patients ◽

Upper Extremities ◽

Rank Test ◽

Dialysis Access ◽

Ptfe Graft ◽

Risk Of Infection ◽

Femoral Catheter

Background Hemodialysis access is a challenging problem in patients with exhausted dialysis access sites of their upper extremities. Femoral arterio-venous polytetrafluoroethylene (PTFE) graft is often necessary. The safety and efficacy of cuffed tunneled catheters at the femoral site for long-term hemodialysis has not been extensively studied. Methods We inserted 14 cuffed-tunneled femoral catheters in 11 hemodialysis patients with exhausted dialysis access sites of their upper extremities. Access survival and risk of infection were compared with the 11 femoral PTFE grafts in 10 patients of our center during the same period. The choice of dialysis access was determined by the individual nephrologist. Access survival was defined as the achievement of a blood flow rate of at least 180 ml/min. Results The median survival of tunneled femoral catheter and PTFE graft were 166 days and 560 days respectively (log-rank test, p = 0.33). Seven of the 14 tunneled femoral catheter remained in use 3 months after insertion. The incidence of catheter- or graft-related infection was 0.38 and 0.23 episodes per 100 catheter / graft days for tunneled femoral catheters and PTFE graft respectively (p = 0.6). Five tunneled catheters and one PTFE graft had to be removed because of infection. Blood flow rates achieved were comparable between tunneled femoral catheter and PTFE graft. Conclusions Our preliminary data suggest that the cuffed tunneled femoral catheter has reasonable access survival and an acceptable risk of infection. It may provide a safe and effective access for long-term hemodialysis patients with exhausted access in their upper extremities, especially high risk patients who are not suitable for femoral PTFE graft creation.

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