Kidney Week

Abstract: SA-PO960

Reasons for Dialysis Catheter Insertion at a National Level – Real Time Data from the REDUCCTION Project

Session Information

• Dialysis: Vascular Access - II
  October 27, 2018 | Location: Exhibit Hall, San Diego Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Dialysis

• 704 Dialysis: Vascular Access

Authors

• Kotwal, Sradha S., The George Institute for Global Health, Sydney, New South Wales, Australia

Sradha S. Kotwal,

• Talaulikar, Girish S., The Canberra Hospital, Garran, Australian Capital Territory, Australia

Girish S. Talaulikar,

• Gray, Nicholas A., Sunshine Coast University Hospital , Birtinya, Queensland, Australia

Nicholas A. Gray,

• Polkinghorne, Kevan, Monash Medical Centre and Monash University, Melbourne, Victoria, Australia

Kevan Polkinghorne,

• McDonald, Stephen P., Royal Adelaide Hospital, Adelaide, South Australia, Australia

Stephen P. McDonald,

• Cass, Alan, Menzies School of Health Research, Darwin, Northern Territory, Australia

Alan Cass,

• Gallagher, Martin P., The George Institute for Global Health, Sydney, New South Wales, Australia

Martin P. Gallagher,

Group or Team Name

• REDUCCTION Project Investigators

Background

Dialysis catheters are inserted for reasons which are not well measured or understood. Understanding reasons for catheter insertion on a real-time basis allows units to measure practice and catheter use in a national context.
We aimed to understand the reasons for dialysis catheter insertion in patients of Australian renal units participating in a prospective national project (Reducing the burden of dialysis catheter complications - REDUCCTION).

Methods

Data was collected using a web-based data collection tool on all patients who had a dialysis catheter inserted between 20/12/2016 and 23/03/2018 (censored) at any of the 37 units participating in the REDUCCTION project. The reasons for insertions were grouped into Acute Kidney Injury (AKI), commencement of maintenance dialysis, arteriovenous fistula/graft (AVF/AVG) dysfunction, transition from Peritoneal Dialysis (PD) without permanent vascular access and other as reported by study site. Study data collection continues.

Results

Data on 3572 (2522 patients) dialysis catheters were captured so far, representing 316,039 catheter days. Of these, 1176 (32.5%; 60% Tunnelled) catheters were inserted for AKI, 1047 (29.4%; 85.8% tunnelled) for commencement of maintenance dialysis, 464 (13%) for AVF/AVG dysfunction, 401 (11.3%) for transition from PD and 481 catheters (13.5%) for other reasons. Twenty-nine catheters were inserted in 27 patients for failing renal transplants. A total of 1075 catheters remained in situ at the censor date while 2497 catheters were removed after a median of 18 days (IQR 6-71 days). The median duration for tunnelled catheters was 75 days (IQR 26-170) and non-tunnelled catheters was 6 (IQR 3-9) days.

Conclusion

This prospective national data highlights the reasons for dialysis catheter exposure, most notably the high burden arising from AKI. Understanding the outcomes, such as catheter-related bacteraemia (the primary outcome of REDUCCTION), for these different patient groups may aid in reducing complications.

Funding

• Government Support - Non-U.S.