PERFORMANCE EVALUATION OF TUNNELED CATHETERS FOR HEMODIALYSIS ACCESS: A DESCRIPTIVE CASE SERIES STUDY

Abstract

Renal failure in hospitalized patients is associated with significant morbidity, mortality, and resource utilization, with up to 18% of patients experiencing this condition. Hemodialysis is widely used as a renal replacement therapy worldwide. However, the long-term maintenance of functional upper extremity vascular access remains challenging for healthcare providers. This study assessed the performance of tunneled catheters used for dialysis access. A total of 97 eligible patients were included from Bahria Town International Hospital Lahore, and their demographic data and the duration of hemodialysis were recorded. The lead investigator inserted a tunneled catheter in each patient for dialysis purposes. After a three-month follow-up period, patients were evaluated for catheter use during their subsequent appointments. Infection was diagnosed if patients were presented with redness, discomfort, or pus. The catheter condition was assessed, noting any signs of breakage, dislodgement, exposed cuff, fractures, or obstructions. Data was collected using a standardized Performa. The study population had an average age of 47.76 ± 16.317 years, with an average duration of dialysis of 6.87 ± 2.754 months. Male patients constituted 60.824%, while female patients accounted for 39.176% of the sample. Catheter placements were performed in the internal jugular vein in 79 (81.44%) individuals, the subclavian vein in 13 (13.40%), and the femoral vein in 5 (5.154%). Infection was observed in 16.49% of patients, while 83.505% remained infection-free. Catheter failure was identified in 5.154% of patients. However, no significant correlations were found between the occurrence of catheter failure and age group, gender, body mass index (BMI), dialysis duration, or catheter site. All the pre-values for these variables were greater than 0.05. Similarly, age group, gender, BMI, dialysis duration, and catheter site did not exhibit a statistically significant association with the presence of infection. Catheter failure in patients with chronic renal disease undergoing continuous hemodialysis was observed in 5.154% of cases, while infection occurred in 16.49%. Age group, gender, BMI, dialysis duration, and catheter location were not found to be significant effect modifiers.