Taurolidine citrate and unfractionated heparin combination versus unfractionated heparin alone in prevention of inflammation in hemodialysis catheters
| Autor: | Amr Mansour, R Mohsen, Khaled Rezk, Ahmed K. Emara, Magdy ElSharkawy, Haitham Ezzat |
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| Rok vydání: | 2020 |
| Předmět: | |
| Zdroj: | QJM: An International Journal of Medicine. 113 |
| ISSN: | 1460-2393 1460-2725 |
| DOI: | 10.1093/qjmed/hcaa052 |
| Popis: | Introduction and Aims Patients on hemodialysis (HD) using dialysis catheters have significantly higher rates of morbidity and mortality which has been associated with chronic inflammatory state. In Egypt 6.6% of HD patients use catheters, of which short term catheters represent 59.6% and 40.4% with long-term catheters. In this study we aim to assess the possible effect of using Taurolidine citrate and unfractionated heparin (Taurolock-hep500™) in comparison to unfractionated heparin, as a lock solution for temporary hemodialysis catheters, on inflammatory status in HD patients. Methods a randomized controlled clinical trial that included 60 stable HD patients recruited from Ain Shams University hospitals at the time of catheter insertion. They were divided into two groups, Group 1: 30 Patients received taurolidine and citrate (4%) and 500 i.u of heparin as a catheter lock solution after hemodialysis sessions, Group 2: 30 patients received unfractionated heparin (5000i.u) as a catheter lock solution after hemodialysis sessions. Standard aseptic techniques were used in handling catheters. High sensitive C-reactive protein (hsCRP) and interleukin 6 (IL-6) were measured in serum for both groups and samples were obtained at baseline and after 1 month of using the lock solutions. Results Group 1 (mean age 39.5 ± 14, 46.7% males), Group 2 (mean of age 39.3 ±14,60% males). At base line, there was no significant difference between both groups regarding hsCRP (P = 0.366) and IL-6 (p = 0.900). While after 1 month of using the lock solution there was significant difference as regard levels of hsCRP (p = 0.001) and IL-6 (p = 0.018),with the higher levels of inflammatory markers showed in group 2. Conclusions we may conclude that the use of Taurolidine citrate and unfractionated heparin combination as a lock solution for HD catheters reduces the inflammatory markers, and the inflammatory status in HD patients when compared to the standard unfractionated heparin lock as demonstrated by reducing the levels of inflammatory markers (hsCRP and IL-6). This may have good clinical consequences regarding the quality of life in HD patients. |
| Databáze: | OpenAIRE |
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