INCIDENCE AND RISK FACTORS OF CATHETER-RELATED COMPLICATIONS AMONG PATIENTS WITH CENTRAL VENOUS AND HEMODIALYSIS CATHETERS PRESENTING TO THE NEPHROLOGY DIVISION, KHYBER TEACHING HOSPITAL, PESHAWAR, PAKISTAN

Abstract

Background: There is a dearth of local, new information comparing the prevalence and risk factors of catheter-related problems between hemodialysis catheters (tunneled versus non-tunneled). Producing such data could enhance patient safety in our context, direct catheter selection, and inform preventative measures.

Objectives:

• To estimate and compare the incidence of catheter-related bloodstream infection (CRBSI) within 30 days of insertion between double-lumen non-tunneled non-cuffed and double-lumen tunneled cuffed hemodialysis catheters.


• To determine the incidence of catheter dysfunction, catheter related thrombosis, mechanical complications and risk factors for catheter related bloodstream infection

Methods: This descriptive comparative study was carried out at the department of Nephrology, KTH Peshawar. Male and female patients aging 18 to 80 years who underwent double lumen hemodialysis catheter (tunneled and non-tunneled type) were enrolled. The patients were compared for catheter related complications including bloodstream infection, catheter dysfunction, thrombosis and mechanical complications.

Results: A total of 180 patients (30 tunneled, 150 non-tunneled) were enrolled. CRBSI incidence was significantly lower in tunneled catheters (0.57 vs. 3.71 per 1000 catheter-days; p=0.046). Catheter dysfunction occurred in 3.3% vs. 10.0% (p=0.480) and catheter-related thrombosis in 3.3% vs. 1.3% (p = 0.410) tunneled versus non-tunneled catheters respectively. Tunneled catheters demonstrated markedly longer median survival (125 vs. 14 days; p<0.001). Univariable analysis showed no significant independent risk factors for CRBSI.

Conclusion: Compared to non-tunneled catheters, tunneled hemodialysis catheters demonstrated reduced infection rates and longer shelf life.