Abstract: SA-PO963
Minimizing Complications During Renal Replacement Therapy with Tunneled Dialysis Catheters in Patients with AKI
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
- Mendez Castaner, Lumen Alberto, Jackson Memorial Hospital, Miami, Florida, United States
- LadinoAvellaneda, Marco A., Miami VA Medical Center/University of Miami/ Jackson Memorial Hospital, Plantation, Florida, United States
- Armstrong, Antonio A., Jackson Memorial Hospital, Miami, Florida, United States
- Cristea, Emilian A., Jackson Memorial Hospital, Miami, Florida, United States
- Cuebas-Rosado, Lorena, Miami VA Hospital, Miami, Florida, United States
- Soberon, Daniel J., Miami VA Hospital, Miami, Florida, United States
- Venkat, Vasuki N., Miami VA Hospital, Miami, Florida, United States
Background
Patients with acute kidney injury that need renal replacement therapy have an increased morbidity and mortality. Bacteremia and poor renal replacement therapy delivery are complications that are present with the use of non-tunneled dialysis catheter. There is not enough data to support which option is the best vascular access to start renal replacement therapy in patients with acute kidney injury. We report our protocol using tunneled dialysis catheters for renal replacement therapy based on our 5-year experience.
Methods
This is a retrospective study of 62 patients with AKI that had indications to start renal replacement therapy. The vascular access for renal replacement therapy was a tunneled dialysis catheter. Patients did not have bacteremia or sepsis prior to catheter placement.
Results
All 62 patients had a tunneled dialysis catheter placed. 14 patients were started on continuous replacement therapy (CRT), 48 patients were started on intermittent hemodialysis (IHD). No infections (bacteremia, exit site infection, tunnelitis) in the first 14 days after tunneled catheter placement were reported. A good clearance was obtained in the patients on CRT with a median duration of the dialyzer (No need for exchange) of 3 days. Appropriate clearance was also obtained in the patients on IHD. Blood flows were appropriate in both modalities.
Conclusion
TDCs should be the vascular access of choice for patients (Figure 1) with AKI in need for dialysis if no contraindications are present (bacteremia, sepsis, hemodynamic instability). Patients didn’t have catheter related infections. Dialysis delivery was always appropriate without complications. The use of TDCs decreases length of stay in the hospital, costs and complications from non-tunneled catheters.