Abstract: SA-PO954
A Randomized, Open-Label Study to Evaluate the Efficacy and Safety of Plastic Cannula Compared with Metal Needle in Incident Hemodialysis Patients
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
- Kim, Sung gyun, Hallym University, Anyang, Korea (the Republic of)
- Joo, Narae, Hallym University, Anyang, Korea (the Republic of)
- Kim, Jwa-kyung, Hallym University, Anyang, Korea (the Republic of)
Background
Successful cannulation of arteriovenous fistula (AVF) is an important issue especially in patients who start hemodialysis. Metal needles have been used for decades, but more recently, the usefulness of plastic cannula has been introduced. In this study, a
Methods
This was a single-center, prospective, randomized, open-label study with incident hemodialysis patients. Eligible patients were randomized into 2 groups in a 1:1 ratio (n=20 in each group). Maturation of AVF was confirmed using Doppler US, and well-trained two nursing staffs implemented AVF cannulation. Primary endpoint was the rate of early successful cannulation, defined as the successful completion of three consecutive dialysis sessions with adequate blood flow rates. Secondary outcomes were incidence of vessel injuries (bruising, swelling, erythema, and hematoma), degree of pain, difficulties during cannulation, and urea clearance. Devices examined were metal needle (JMS, 16G, Singapore), and plastic cannula (Supercath Clampcath®, 17G, Togo Medikit, Japan).
Results
Among the 40 patients, radiocephalic AVFs were 47.5 % (n=19) and mean duration from AVF creation to first cannulation was 51.7 ± 26.5 days. No significant difference was found between groups with respect to patient age, sex, prevalence of diabetes, or types of AVF. Failure of early successful cannulation was observed in 9 patients, and the failure risks tended to be higher in metal group (2 cases in plastic group, but 7 cases in metal group, p=0.060). In addition, the risk of vessel injury was significantly higher in metal group than in plastic group (44.4% vs 11.1%, p=0.030). However, the degrees of pain that patients feel was slightly higher in plastic group than in metal group (4.5 vs. 2.9, p=0.066). The difficulties during cannulation felt by nursing staffs or urea clearance were similar in both groups.
Conclusion
Use of plastic cannulas provided less vascular injury and may increase the rate of successful cannulation especially in early period of dialysis. It could be a new and innovative tool for improve dialysis quality.