Comparison of the clinical effects between catheter exchange methods in geriatric patients with tunneled cuffed hemodialysis catheters
10.3760/cma.j.issn.0254-9026.2012.09.011
- VernacularTitle:老年肾病患者应用半永久导管透析不同换管方式的临床疗效比较
- Author:
Canxin ZHOU
;
Hua JIANG
;
Jianghua CHEN
- Publication Type:Journal Article
- Keywords:
Renal dialysis;
Catheterization;
Catheters,indwelling
- From:
Chinese Journal of Geriatrics
2012;31(9):782-785
- CountryChina
- Language:Chinese
-
Abstract:
Objective To compare the infection free and overall survival between first and subsequent tunneled cuffed hemodialysis catheters in geriatric patients.Methods The study involved57 geriatric patients [32 male,25 female; mean age (72.4 ± 6.7) years]undergoing maintenance hemodialysis in our blood purfication unit over a period of 72 months.Among a total of 131 catheters and 2686 catheter months including 57 first catheters and 74 consecutive catheters,48 wire guided exchange (WGE) and 26 removal and replacement (RAR),55/131 (42.0％) catheters were exchanged because of catheter-related bacteremia (CRB),37131 (28.2％) exchanged because of malfunction or cuff extrusion,39 /131 (29.9％)catheters were removed electively or was still functional at the end of the study period.Results One-year survival rates for first and consecutive catheters were 35.8％ and 28.4％,respectively.There was no difference in the overall survival between first catheters group and subsequent catheters group [(29.8±7.9)months vs.(28.7±6.0)months,t=0.711,P=0.443].However,infection free survival of first catheters group was significantly prolonged in comparison with that of subsequent catheters group [(13.1 ± 3.5) months vs.(11.6±2.7) months,t =2.415,P=0.018].The overall and infection-free survival in WGE group were not different with those of RAR group [(28.2 ± 7.2 ) months vs.( 28.5 ± 5.8 ) months,(11.1±3.1)months vs.(12.2±2.1)months,t=-0.163,0.103,P＞0.05].The infection free survival of first catheters group and WGE group was prolonged in comparison with that of in situ group[(13.1±3.5)months and (11.1±3.1)months vs.(8.2±2.1)months,t =7.602,5.601,P＜0.05].Conclusions WGE is safe and effective in the elderly patients if the tunnel and the exit site are not infected and has the potential benefit of preserving the vascular access site.
