A cross-sectional study on non-infectious dysfunction of hemodialysis cuffed catheter

TL;DR

This study identifies common causes of dysfunction in dialysis cuffed catheters and suggests ways to improve their function.

Contribution

The study provides insights into the causes of cuffed catheter dysfunction and suggests strategies to prolong catheter life.

Findings

Catheter-related thrombosis was the most common cause of dysfunction.

Left-side catheters had higher dysfunction rates compared to right-side catheters.

Most dysfunction occurred within 3 months of catheter placement.

Abstract

Dialysis cuffed catheter dysfunction results in inadequate dialysis, increased sepsis risk, and a shortened catheter life. It may be possible to prolong catheter function by identifying the causes of cuffed catheter dysfunction.

This study was a cross-sectional descriptive study conducted in 2021-2022 on hemodialysis patients with jugular cuff catheters. The catheterizations were performed using the Seldinger technique and were confirmed by fluoroscopy. A 12-month follow-up was conducted with respect to the performance of the cuffed catheter.

A total of 123 patients underwent hemodialysis over 2 years via a cuffed catheter. Catheters were most commonly inserted into the right internal jugular vein, with lengths of 19 cm (tip to cuff). The rate of dysfunction of cuffed catheters was 27.6%. Catheter-related thrombosis was the most common cause in 10 cases (29.4%), followed by catheter tip fibrin sheath in 8 cases (23.5%) and catheter tip malposition in 8 cases (23.5%). Furthermore, 18 patients (52.94%) of cuffed catheter dysfunction occurred within 3 months of catheter placement, based on our study. The dysfunction of cuffed catheters on the left side 23 (67.64%) is more prevalent than the right side 11 (32.35%) (P=0.043); the malposition of catheter tips is more prevalent on the left side (P=0.023).

Most commonly, cuffed catheter dysfunction is caused by thrombosis, fibrin sheath formation, and catheter tip malposition. Cuffed catheter failure can be reduced by carefully monitoring the catheter's path and tip position, searching for fibrin sheaths when investigating cuffed catheter failure, and preventing thrombotic events.