Non-tunneled versus tunneled dialysis catheters for acute kidney injury requiring renal replacement therapy: a prospective cohort study

Autor: Megan F. May, Dionne A. Graham, Naomi S. Shin, Mallika L. Mendu, Ayal A. Aizer, Margaret E. Chen, Salena Cui, Arnaud D. Kaze, Sushrut S. Waikar
Rok vydání: 2017
Předmět:
Male
Nephrology
medicine.medical_specialty
medicine.medical_treatment
030232 urology & nephrology
030204 cardiovascular system & hematology
lcsh:RC870-923
urologic and male genital diseases
Cohort Studies
Tunneled dialysis catheter (TDC)
03 medical and health sciences
0302 clinical medicine
Renal Dialysis
Internal medicine
medicine
Central Venous Catheters
Humans
Prospective Studies
Renal replacement therapy
Prospective cohort study
Dialysis
Aged
Acute kidney injury (AKI)
Continuous venovenous hemofiltration (CVVH)
business.industry
Acute kidney injury
Dialysis catheter
Acute Kidney Injury
Middle Aged
lcsh:Diseases of the genitourinary system. Urology
medicine.disease
female genital diseases and pregnancy complications
Intermittent hemodialysis (IHD)
Renal Replacement Therapy
Catheter
Non-tunneled dialysis catheter (NTDC)
Anesthesia
Female
Renal replacement therapy (RRT)
business
Research Article
Kidney disease
Zdroj: BMC Nephrology, Vol 18, Iss 1, Pp 1-7 (2017)
BMC Nephrology
ISSN: 1471-2369
Popis: Background Acute kidney injury requiring renal replacement therapy (AKI-RRT) is associated with high morbidity, mortality and resource utilization. The type of vascular access placed for AKI-RRT is an important decision, for which there is a lack of evidence-based guidelines. Methods We conducted a prospective cohort study over a 16-month period with 154 patients initiated on AKI-RRT via either a non-tunneled dialysis catheter (NTDC) or a tunneled dialysis catheter (TDC) at an academic hospital. We compared differences in renal replacement delivery and mechanical and infectious outcomes between NTDCs and TDCs. Results Patients who received TDCs had significantly better RRT delivery, both with continuous venovenous hemofiltration (CVVH) and intermittent hemodialysis (IHD), compared to patients who received NTDCs; these findings were confirmed after multivariable adjustment for AKI-specific disease severity score, history of chronic kidney disease, renal consult team, and AKI cause. In CVVH and IHD, the median venous and arterial blood flow pressures were significantly higher with TDCs compared to NTDCs (p
Databáze: OpenAIRE
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