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Objectives: The use of central venous catheters as hemodialysis (HD) vascular access is associated with worsemorbidity and mortality in HD patients. This occasion is often attributed to comorbidities of the patients withcentral venous catheters. Studies reveal that a biofilm layer occurs on most of the tunneled-cuffed centralvenous catheters (TC-CVCs). This study aimed to determine the oxidative stress (OS) and systemicinflammation (SI) status in patients with TC-CVCs as HD vascular access without clinical signs and symptomsof infection.Methods: The study is composed of eighty-five patients with a minimum HD vintage of one year. Patientswith a history of infection or a cardiovascular event within six months, malignancy, systemic inflammatorydiseases, or malnutrition were excluded. OS indices and SI markers were studied and compared in patientswith arteriovenous fistula (AVF) and TC-CVCs.Results: Mean native thiol/total thiol (NT/TT) ratio was significantly higher and mean disulphide/total thiol(DT/TT) ratio was significantly lower in AVF group comparing TC-CVC group (0.46 ± 0.17 and 0.36 ± 0.17,p = 0.03 for NT/TT; 0.27 ± 0.08 and 0.31 ± 0.08, p = 0.04 for DS/TT; respectively). Mean OS index wassignificantly lower in the AVF group comparing TC-CVC group (0.15 ± 0.14 and 0.24 ± 0.23, p = 0.04;respectively]. Median hs-CRP levels and median IL-6 levels were significantly lower in AVF group comparingTC-CVC group (5.8 [min: 3.0-max: 82.5] mg/L and 9.7 [min: 3.0-max: 45.4] mg/L, p = 0.004 for hs-CRP; 6.2[min: 2.0-max:159.0] pg/mL and 12.2 [min: 2.6-max: 41.3) pg/mL, p = 0.01 for IL-6; respectively).Conclusions: TC-CVCs inversely affect OS and systemic inflammatory status in HD patients, presumablydue to foreign body reactions and biofilm layers.Keywords: Arteriovenous fistula, central venous catheters, hemodialysis vascular access, oxidative stress,systemic inflammation |
