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2016 ; 9
(ä): 87-94
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Conversion from temporary to tunneled catheters by nephrologists: report of a
single-center experience
#MMPMID27114715
Silva BC
; Rodrigues CE
; Abdulkader RC
; Elias RM
Int J Nephrol Renovasc Dis
2016[]; 9
(ä): 87-94
PMID27114715
show ga
BACKGROUND: Nephrologists have increasingly participated in the conversion from
temporary catheters (TC) to tunneled-cuffed catheters (TCCs) for hemodialysis.
OBJECTIVE: To prospectively analyze the outcomes associated with TCC placement by
nephrologists with expertise in such procedure, in different time periods at the
same center. The impact of vancomycin or cefazolin as prophylactic antibiotics on
the infection outcomes was also tested. PATIENTS AND METHODS: Hemodialysis
patients who presented to such procedure were divided into two cohorts: A (from
2004 to 2008) and B (from 2013 to 2015). Time from TC to TCC conversion,
prophylactic antibiotics, and reasons for TCC removal were evaluated. RESULTS:
One hundred and thirty patients were included in cohort A and 228 in cohort B.
Sex, age, and follow-up time were similar between cohorts. Median time from TC to
TCC conversion was longer in cohort A than in cohort B (14 [3; 30] vs 4 [1; 8]
days, respectively; P?0.0001). Infection leading to catheter removal occurred in
26.4% vs 18.9% of procedures in cohorts A and B, respectively, and infection rate
was 0.93 vs 0.73 infections per 1,000 catheter-days, respectively (P=0.092).
Infection within 30 days from the procedure occurred in 1.4% of overall cohort.
No differences were observed when comparing vancomycin and cefazolin as
prophylactic antibiotics on 90-day infection-free TCC survival in a Kaplan-Meier
model (log-rank = 0.188). TCC removal for low blood flow occurred in 8.9% of
procedures. CONCLUSION: Conversion of TC to TCC by nephrologists had overall
infection, catheter patency, and complications similar to data reported in the
literature. Vancomycin was not superior to cefazolin as a prophylactic
antibiotic.