Kemal MAĞDEN
(Bülent Ecevit Üniversitesi Tıp Fakültesi, Nefroloji Anabilim Dalı, Zonguldak, Türkiye)
Bilal TOKA
(Bülent Ecevit Üniversitesi, Tıp Fakültesi, İç Hastalıkları Anabilim Dalı, Zonguldak, Türkiye)
İbrahim YILDIRIM
(Bülent Ecevit Üniversitesi, Tıp Fakültesi, Nefroloji Anabilim Dalı, Zonguldak, Türkiye)
Gürsel YILDIZ
(Atatürk Devlet Hastanesi, Nefroloji Kliniği, Zonguldak, Türkiye)
FÜRÜZAN KÖKTÜRK
(Bülent Ecevit Üniversitesi, Tıp Fakültesi, Biyoistatistik Anabilim Dalı, Zonguldak, Türkiye)
Cem CİL
(Bülent Ecevit Üniversitesi, Tıp Fakültesi, Kardiyoloji Anabilim Dalı, Zonguldak, Türkiye)
Nesimi YAVUZ
(Bülent Ecevit Üniversitesi, Tıp Fakültesi, Kardiyoloji Anabilim Dalı, Zonguldak, Türkiye)
Ender HÜR
(Bülent Ecevit Üniversitesi, Tıp Fakültesi, Nefroloji Anabilim Dalı, Zonguldak, Türkiye)
Yıl: 2019Cilt: 28Sayı: 1ISSN: 1300-7718 / 2667-4440Sayfa Aralığı: 43 - 47İngilizce

3 0
Risk Factors for Catheter Related Central Venous Thrombosis in Hemodialysis Patients
Objective: Permanent catheters are used for vascular access in some patients undergoing hemodialysis (HD). Our aim in this study was to evaluate the risk factors of permanent catheter thrombosis and the necessity of anti-coagulant and anti-aggregation drugs. Materials and Methods: In this retrospective study, 34 patients undergoing HD, with removed internal jugulary permanent catheters due to either thrombosis or maturation of operated arteriovenous fistulas, were included. Patients were divided into thrombotic and non-thrombotic, according to the catheter thrombosis status. Results: The mean age was 66.3±15.4 years, and the follow-up period was 10.9±8.5 (1-29) months. Catheter thrombosis was found in 12 patients. Albumin and total protein levels were lower in the baseline thrombotic group (3.53±0.46 g/dL and 6.64±0.92g/dL, respectively)than in the non-thrombotic group (3.95±0.41 and 7.37±0.46g/dL, respectively).In the non-thrombotic group, hemoglobin, hematocrit higher, and platelet count were lower at the catheter removal time compared to the catheter insertion time (hemoglobin 11.45±1.25, hematocrit 35.61±4.51, and platelet count 193.82±66.32 versus hemoglobin 10.33±1.37g/dL, hematocrit 31.38±3.79% and platelet count 231.77±71.7x103/uL, respectively), but in the thrombotic group, the ferritin levels significantly increased from 541.3±574.8ng/mL at the catheter insertion time to 745.1±406.5ng/mL at the catheter removal time. Conclusion: Anti-coagulant and anti-aggregation drugs and renal failure etiology did nothave any effect on permanent catheter thrombosis, but the albumin and total protein levels were related to it. Increased levels of ferritin and C-reactive protein seem to emerge as the acute phase reactants associated with thrombosis.
DergiAraştırma MakalesiErişime Açık
  • 1. Hodges TC, Fillinger M, Zwolak RM, Walsh DB, Bech F, Cronenwett JL: Longitudinal comparison of dialysis access methods: risk factors for failure. J Vasc Surg 1997; 26: 1009-19. [CrossRef]
  • 2. National Kidney Faondation-Dialysis Outcomes Quality Initiative. In: Schwab S, Besarab A, Beathard G. eds. NKFDOQI Clinical practice guidelines for vascular Access. New York: National Kidney Foundation; 1997.
  • 3. Canaud B, Desmeules S, Klouche K, Leray-MH, Béraud JJ. Vascular access for dialysis in the intensive care unit. Best Pract Res Clin Anaesthesiol 2004; 18: 159-74. [CrossRef]
  • 4. Saudan P, Niederberger M, De Seigneux S, Romand J, Pugin J, Perneger T, et al. Adding a dialysis dose to continuous hemofiltration increases survival in patients with acute renal failure. Kidney Int 2006; 70: 1312-7. [CrossRef]
  • 5. Chan MR. Hemodialysis central venous catheter dysfunction. Semin Dial 2008; 21: 516-21. [CrossRef]
  • 6. Hermite L, Quenot JP, Nadji A, Barbar SD, Charles PE, Hamet M, et al. Sodium citrate versus saline catheter locks for non-tunneled hemodialysis central venous catheters in critically ill adults: a randomized controlled trial. Intensive Care Med 2012; 38: 279-85. [CrossRef]
  • 7. Baskin JL, Pui CH, Reiss U, Wilimas JA, Metzger ML, Ribeiro RC, et al. Management of occlusion and thrombosis associated with long-term indwelling central venous catheters. Lancet 2009; 374: 159-69. [CrossRef]
  • 8. Mickley V. Central venous catheters: many questions, few answers. Nephrol Dial Transplant 2002; 17: 1368-73. [CrossRef]
  • 9. Oguzkurt L, Tercan F, Torun D, Yıldırım T, Zumrutdal A, Kızılkılıc O. Impact of short-term hemodialysis catheters on the central veins: a catheter venographic study. Eur J Radiol 2004; 52: 293-9. [CrossRef]
  • 10. Feldman HI, Held PJ, Hutchinson JT, Stoiber E, Hartigan MF, Berlin JA. Hemodialysis vascular access morbidity in the United States. Kidney Int 1993; 43: 1091-6. [CrossRef]
  • 11. Sands JJ, Miranda CL. Prolongation of hemodialysis Access survival with elective revision. Clin Nephrol1995; 44: 329-33.
  • 12. Prischl FC, Kirchgatterer A, Brandstatter E, Wallner M, Baldinger C, Roithinger FX, et al. Parameters of prognostic relevance to the patency of vascular access in hemodialysis patients. J Am Soc Nephrol 1995; 6: 1613-8.
  • 13. Andrews DA, Pyrah IT, Boren BM, Tannehill-Gregg SH, Lightfoot-Dunn RM. High hematocrit resulting from administration of erythropoiesis-stimulating agents is not fully predictive of mortality or toxicities in preclinical species. Toxicol Pathol 2014; 42: 510-23.[CrossRef]
  • 14. Besarab A, Pandey R. Catheter management in hemodialysis patients, delivering adequate flow. Clin J Am Soc Nephrol 2011; 6: 227- 34.[CrossRef]
  • 15. Dwyer A. Surface-treated catheters-a review. Semin Dial 2008; 21: 542-6.[CrossRef]
  • 16. Zellweger M, Bouchard J, Raymond CS, Laforest RA, Quérin S, Madore F. Systemic anticoagulation and prevention of hemodialysis catheter malfunction. ASAIO J 2005; 51: 360-5. [CrossRef]
  • 17. Mandolfo S, Gallieni M: Use of oral anticoagulantstopreventcentralvenouscatheter-relatedthrombosis in hemodialysis. G Ital Nefrol 2010; 27: 490-7.
  • 18. Ervo S, Cavatorta F, Zollo A. Implantation of permanent jugular catheters in patients on regular dialysis treatment: ten years’ experience. J Vasc Access 2001; 2: 68-72. [CrossRef]
  • 19. Zhang P, Yuan J, Chen JH, Wu JY, Zhang XH, Jiang H: [Complications related to permanent deep venous catheterization using dual lumen hemodialysis catheter]. Zhonghua Nei Ke Za Zhi 2004; 43: 198-200.
  • 20. Chan KE, Lazarus JM, Thadhani R, Hakim RM. Anticoagulant and antiplatelet usage associates with mortality among hemodialysis patients. J Am Soc Nephrol 2009; 20: 872-81. [CrossRef]
  • 21. Bennett WM. Should dialysis patients ever receive warfarin and for what reasons? Clin J Am Soc Nephrol 2006; 1: 1357-9. [CrossRef]
  • 22. Folsom AR, Lutsey PL, Heckbert SR, Cushman M. Serum albumin and risk of venous thromboembolism. Thromb Haemost 2010; 104: 100-4. [CrossRef]

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