Outcome of Cuffed Tunneled Dialysis Catheters for Hemodialysis Patients at a Tertiary Care Hospital: A Descriptive Cross-sectional Study

  • Kajan Raj Shrestha Department of Cardiothoracic Vascular Surgery, Manmohan Cardiothoracic Vascular and Transplant Center, Institute of Medicine, Maharajgunj, Kathmandu, Nepal.
  • Dinesh Gurung Department of Cardiothoracic Vascular Surgery, Manmohan Cardiothoracic Vascular and Transplant Center, Institute of Medicine, Maharajgunj, Kathmandu, Nepal.
  • Uttam Krishna Shrestha Department of Cardiothoracic Vascular Surgery, Manmohan Cardiothoracic Vascular and Transplant Center, Institute of Medicine, Maharajgunj, Kathmandu, Nepal.
Keywords: catheter; hemodialysis; vascular access.

Abstract

Introduction: Arteriovenous fistula is the most common vascular access for patients requiring
hemodialysis, but it is not always possible or practical hence cuffed tunneled dialysis catheter
comes into play. The aim of the study was to determine the outcome of cuffed tunneled dialysis
catheter used for hemodialysis at a teaching hospital.


Methods: A descriptive cross-sectional study was conducted between January 2014 and December
2019 on 103 chronic dialysis patients with end-stage renal disease presenting to a tertiary care
hospital. Ethical approval was received from the institutional review board (2/(6-11) E2/076/77).
Whole sampling was done. Data entry and analysis were done in Microsoft Excel 10.


Results: The study included 103 patients with 117 cuffed tunneled dialysis catheters placed for
hemodialysis. On assessing the outcome of the catheters, the primary and secondary patency
rates of the catheters were 5.85±4.87 and 1.21±3.77 months. Thirty-one (30.1%) patients required
one intervention, and 11 (10.68%) catheters required 3 or more interventions to maintain patency.
Eighteen (17.48%) patients presented with catheter dysfunction while in 11 (10.68%) cases, the
catheter was kinked or malpositioned at the notch. In one patient, procedure was abandoned due
to severe bleeding and in 2 (1.94%) patients dialysis catheters could not be negotiated into the right
atrium and left in brachiocephalic junction.


Conclusions: Cuffed tunneled dialysis catheter is effective for maintenance hemodialysis in patients
with the end-stage renal disease if used with proper care during dialysis even in our setup. The
results and outcomes of the procedure are at par with standards.

Published
2020-06-30
How to Cite
Shrestha, K. R., Gurung, D., & Krishna Shrestha, U. (2020). Outcome of Cuffed Tunneled Dialysis Catheters for Hemodialysis Patients at a Tertiary Care Hospital: A Descriptive Cross-sectional Study. Journal of Nepal Medical Association, 58(226). https://doi.org/10.31729/jnma.4795