2025/12/16 by Matej Zrimšek, Jakob Gubenšek · 1 voice
Health Professions · Medicine · #Central Venous Catheters and Hemodialysis #Dialysis and Renal Disease Management #Vascular Procedures and Complications
paper · pdf · doi:10.1093/ckj/sfaf392
openalex created_date 2025/12/16 · openalex publication_date 2025/12/16 · openalex updated_date 2026/07/30
ABSTRACT Background A hemodialysis catheter may serve as a short- or medium-term vascular access solution. Current guidelines suggest restricting non-tunneled catheter use to 2 weeks, partially based on studies using straight non-tunneled jugular catheters, which have now been widely replaced with pre-curved catheters. We compared the rate of catheter-related blood stream infections (CRBSIs) and possible CRBSIs (PCRBSIs) of pre-curved non-tunneled and tunneled catheters in our hemodialysis center. Methods This was a retrospective study including patients dialyzed on an outpatient basis between 1 January 2018 and 1 July 2024, with a follow-up until 1 March 2025. The primary aim was to compare the rates of CRBSIs. Results In 301 patients, 625 non-tunneled single lumen catheter pairs and 53 double lumen tunneled catheters were used. There were 53 CRBSIs in non-tunneled and 10 in tunneled catheters, with identical incidence rate (0.48/1000 catheter-days in both groups). Analyzing CRBSIs and PCRBSIs together also showed similar infection rates [0.66 vs 0.58, incidence rate ratio (IRR) with 95% confidence interval 1.14 (0.6–2.1), P = .68]. Two subanalyses were made: CRBSI IRR in 27 patients with both types of catheters during study period was 1.37 (0.55–3.41, P = .49) and 2.01 (0.52–7.72, P = .47) in 36 patients after their first CRBSI. Time to CRBSI was also comparable in all analyses. Conclusions Our study found no significant difference in the incidence of CRBSIs. We conclude that prolonged use of non-tunneled pre-curved catheters, which are easily managed, is a viable option for patients awaiting construction of arteriovenous fistula, insertion of a peritoneal catheter or kidney transplantation in a reasonable time. Promising results on long-term use from this study need to be confirmed in prospective studies.