Hemodialysis Access Complications during the first 30 days; Single Center  Experience

Habas Elmukhtar; Emsad  Salha; Kanonie  Wadie

doi:10.54361/

Authors

Habas Elmukhtar consultant Nephrology, Medical Department, Tripoli faculty of Medicine, Tripoli University Author
Emsad Salha Medical Department, Nephrology Unit Author
Kanonie Wadie Medical Department, Medical Intensive Care Unit Author

DOI:

https://doi.org/10.54361/

Keywords:

Hemodialysis catheter, double lumen catheter blockage, HD catheter infection, septicemia

Abstract

Background Temporary hemodialysis (HD) catheter is required mostly in acute and sometimes in chronic renal failure and in other cases. HD catheter is not free of complications. Aim of the study To assess the common complications occur during HD-catheter insertion and during the first 30-days of insertion. Method Two hundred-ten patients had temporary HD catheter been inserted in Tripoli Central Hospital and other private clinics in Tripoli. Patients had questionnaire that prepared about the complications. Patients were divided into three groups according to the site of HD catheter insertion at presentation. The complications detected by patients and/or following up doctors reported in the same questionnaire sheet. The data was collected at the end of 30 days after HD-catheter insertion and analyzed for demographic patients feature, and the complications reported at insertion and during the first 30 days. Statistical analysis Frequency and percentage of commonly occurred complications were analyzed by IBM-SPSS statistical package version 18 program (SPSS inc., Chicago III, USA). Results Included patients were divided into three groups. Group A: 95 patients had catheter at the jugular veins. Group B: 73 patients had femoral vein canalization, and group C: 42 patients had subclavian vein catheterization. Group A were 65 male and 30 female patients, group B were 42 males and 31 females, and group C had 30 males, and 12 females. Patients mean age was 55.1 years ± 5.12 and (22 – 68) years of age. Patients included in the study were randomly allocated into the three groups as they were presented. Pain at the site of insertion and during the first 12 hours was the commonest complications (72.9%), and pain around the insertion site during the first 12 hours reported by 102 (48.6%) patients. Infection at the site of insertion reported in 38.6% of patients. Femoral vein catheterization entrance site infection reported in 45 (55.6%), at subclavian reported in 15 (18.5%) and at jugular veins in 21 (25.9%) patients. Catheter tunnel infection was reported in 11 (5.2%) patients. Catheter tunnel infection was reported more with femoral catheter. Arterial or venous HD catheter lumen blockage reported in 46 (21.9%). Two lumens blockage reported in 61 (29%) patients. Bleeding from the entrance site of the catheter reported during HD sessions reported in 10 (4.8%) patients. Hematoma at insertion site or around it was reported in 52 (24.8%) patients. It was more after femoral vein catheterization 28 (53.8%) followed by jugular 18 (34.6%) and then subclavian catheterization 6 (11.5%) patients. Conclusion Pain and infection at the insertion site were the commonest complications of HD catheter insertion. Reducing the rate of these complications depends mainly upon implanting strict septic techniques, and train doctors and nurses about HD insertion complications and

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