Sodium Citrate Versus Heparin Locking Solutions for Tunneled Hemodialysis Catheters

Detalhes bibliográficos
Autor(a) principal: Alves,Patrícia
Data de Publicação: 2023
Outros Autores: Veríssimo,Rita, Mendes,Artur
Tipo de documento: Artigo
Idioma: eng
Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
Texto Completo: http://scielo.pt/scielo.php?script=sci_arttext&pid=S0872-01692023000100017
Resumo: ABSTRACT Introduction: Hemodialysis catheter dysfunction compromises dialysis adequacy and may limit catheter survival. Strategies to prevent hemodialysis catheter dysfunction include catheter locks, generally either with heparin or citrate. Methods: Our hemodialysis unit converted to locking all central venous hemodialysis catheters with sodium citrate 4% instead of heparina 5000 U/mL. A retrospective analysis compared the outcomes of the 6 months prior and after the conversion. The compared outcomes were incidence of catheter thrombosis, catheter-related infection, flow-related catheter exchange rate, dialysis efficiency measured by Kt/V and catheter dysfunction. Results: Twenty-three patients were included. Between the two audit periods, the rate of catheter thrombosis was 0 (0 per 1000 catheter days) and 7 (2.78 per 1000 catheter days) during the heparin and citrate period respectively (p=0.109). The number of catheter exchanges due to catheter dysfunction was 0 (0 per 1000 catheter days) during the heparin period and just 1 (0.39 per 1000 catheter days) during the citrate period (p=0.317). Dialysis adequacy measured by KT/V was 1.54 (0.39) in the heparin group and 1.54 (0.35) in the citrate group (p=0.465). Catheter dysfunction was recorded in 146 sessions (12.3%) in the heparin period and in 159 sessions (14,7%) in the citrate period (p=0.234). There were no catheter related infections in either group. Conclusion: There was a 58% cost reduction associated with catheter-locking therapy between the heparin period and the citrate period. This cost reduction included the costs associated with alteplase use. Besides the financial advantages in switching to citrate locking, there are other potential advantages, namely the minimization of heparin related side effects or limitations.
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spelling Sodium Citrate Versus Heparin Locking Solutions for Tunneled Hemodialysis CathetersCatheter-Related InfectionsCatheterization, Central VenousCatheters, IndwellingHeparinRenal DialysisSodium CitrateABSTRACT Introduction: Hemodialysis catheter dysfunction compromises dialysis adequacy and may limit catheter survival. Strategies to prevent hemodialysis catheter dysfunction include catheter locks, generally either with heparin or citrate. Methods: Our hemodialysis unit converted to locking all central venous hemodialysis catheters with sodium citrate 4% instead of heparina 5000 U/mL. A retrospective analysis compared the outcomes of the 6 months prior and after the conversion. The compared outcomes were incidence of catheter thrombosis, catheter-related infection, flow-related catheter exchange rate, dialysis efficiency measured by Kt/V and catheter dysfunction. Results: Twenty-three patients were included. Between the two audit periods, the rate of catheter thrombosis was 0 (0 per 1000 catheter days) and 7 (2.78 per 1000 catheter days) during the heparin and citrate period respectively (p=0.109). The number of catheter exchanges due to catheter dysfunction was 0 (0 per 1000 catheter days) during the heparin period and just 1 (0.39 per 1000 catheter days) during the citrate period (p=0.317). Dialysis adequacy measured by KT/V was 1.54 (0.39) in the heparin group and 1.54 (0.35) in the citrate group (p=0.465). Catheter dysfunction was recorded in 146 sessions (12.3%) in the heparin period and in 159 sessions (14,7%) in the citrate period (p=0.234). There were no catheter related infections in either group. Conclusion: There was a 58% cost reduction associated with catheter-locking therapy between the heparin period and the citrate period. This cost reduction included the costs associated with alteplase use. Besides the financial advantages in switching to citrate locking, there are other potential advantages, namely the minimization of heparin related side effects or limitations.Sociedade Portuguesa de Nefrologia2023-03-01info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articletext/htmlhttp://scielo.pt/scielo.php?script=sci_arttext&pid=S0872-01692023000100017Portuguese Journal of Nephrology & Hypertension v.37 n.1 2023reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAPenghttp://scielo.pt/scielo.php?script=sci_arttext&pid=S0872-01692023000100017Alves,PatríciaVeríssimo,RitaMendes,Arturinfo:eu-repo/semantics/openAccess2024-02-06T17:05:16Zoai:scielo:S0872-01692023000100017Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-20T02:19:09.123969Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse
dc.title.none.fl_str_mv Sodium Citrate Versus Heparin Locking Solutions for Tunneled Hemodialysis Catheters
title Sodium Citrate Versus Heparin Locking Solutions for Tunneled Hemodialysis Catheters
spellingShingle Sodium Citrate Versus Heparin Locking Solutions for Tunneled Hemodialysis Catheters
Alves,Patrícia
Catheter-Related Infections
Catheterization, Central Venous
Catheters, Indwelling
Heparin
Renal Dialysis
Sodium Citrate
title_short Sodium Citrate Versus Heparin Locking Solutions for Tunneled Hemodialysis Catheters
title_full Sodium Citrate Versus Heparin Locking Solutions for Tunneled Hemodialysis Catheters
title_fullStr Sodium Citrate Versus Heparin Locking Solutions for Tunneled Hemodialysis Catheters
title_full_unstemmed Sodium Citrate Versus Heparin Locking Solutions for Tunneled Hemodialysis Catheters
title_sort Sodium Citrate Versus Heparin Locking Solutions for Tunneled Hemodialysis Catheters
author Alves,Patrícia
author_facet Alves,Patrícia
Veríssimo,Rita
Mendes,Artur
author_role author
author2 Veríssimo,Rita
Mendes,Artur
author2_role author
author
dc.contributor.author.fl_str_mv Alves,Patrícia
Veríssimo,Rita
Mendes,Artur
dc.subject.por.fl_str_mv Catheter-Related Infections
Catheterization, Central Venous
Catheters, Indwelling
Heparin
Renal Dialysis
Sodium Citrate
topic Catheter-Related Infections
Catheterization, Central Venous
Catheters, Indwelling
Heparin
Renal Dialysis
Sodium Citrate
description ABSTRACT Introduction: Hemodialysis catheter dysfunction compromises dialysis adequacy and may limit catheter survival. Strategies to prevent hemodialysis catheter dysfunction include catheter locks, generally either with heparin or citrate. Methods: Our hemodialysis unit converted to locking all central venous hemodialysis catheters with sodium citrate 4% instead of heparina 5000 U/mL. A retrospective analysis compared the outcomes of the 6 months prior and after the conversion. The compared outcomes were incidence of catheter thrombosis, catheter-related infection, flow-related catheter exchange rate, dialysis efficiency measured by Kt/V and catheter dysfunction. Results: Twenty-three patients were included. Between the two audit periods, the rate of catheter thrombosis was 0 (0 per 1000 catheter days) and 7 (2.78 per 1000 catheter days) during the heparin and citrate period respectively (p=0.109). The number of catheter exchanges due to catheter dysfunction was 0 (0 per 1000 catheter days) during the heparin period and just 1 (0.39 per 1000 catheter days) during the citrate period (p=0.317). Dialysis adequacy measured by KT/V was 1.54 (0.39) in the heparin group and 1.54 (0.35) in the citrate group (p=0.465). Catheter dysfunction was recorded in 146 sessions (12.3%) in the heparin period and in 159 sessions (14,7%) in the citrate period (p=0.234). There were no catheter related infections in either group. Conclusion: There was a 58% cost reduction associated with catheter-locking therapy between the heparin period and the citrate period. This cost reduction included the costs associated with alteplase use. Besides the financial advantages in switching to citrate locking, there are other potential advantages, namely the minimization of heparin related side effects or limitations.
publishDate 2023
dc.date.none.fl_str_mv 2023-03-01
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dc.publisher.none.fl_str_mv Sociedade Portuguesa de Nefrologia
publisher.none.fl_str_mv Sociedade Portuguesa de Nefrologia
dc.source.none.fl_str_mv Portuguese Journal of Nephrology & Hypertension v.37 n.1 2023
reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação
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instname_str Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação
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reponame_str Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
collection Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
repository.name.fl_str_mv Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação
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