Systematic review of locking solutions for non-tunneled hemodialysis catheters.

Abstract

BACKGROUND:

We conducted a systematic review of studies investigating lock solutions for use in non-tunneled hemodialysis catheters.

METHODS:

We searched PubMed and Cochrane databases from inception to June 11, 2021. Study inclusion criteria were: randomized trial or observational study, adults (>18 years), with acute kidney injury (AKI); and temporary non-tunneled catheters. We recorded bleeding events, catheter dysfunction and complications.

RESULTS:

Of 649 studies identified, 6 were included (4 randomized, 1 non-randomized trial, 1 retrospective cohort study; sample sizes 78-1496 patients). Citrate was compared to heparin in 4 studies, to saline in 1, and ethanol versus saline in 1. Event-free survival of non-tunneled catheters did not differ between groups. Catheter-related infections and adverse events were less frequent with citrate locks, but reached statistical significance in only two studies.

CONCLUSION:

Existing data are too heterogeneous to enable recommending one type of catheter lock over any other for non-tunneled hemodialysis catheters.

• Authors: Isabelle Boucley, Auguste Dargent, Pascal Andreu, Jean-Baptiste Roudaut, François Aptel, Marie Labruyère, Marine Jacquier, Amélie Cransac, Jean-Pierre Quenot
• Journal: Hemodialysis international. International Symposium on Home Hemodialysis (Hemodial Int) Vol. 27 Issue 1 Pg. 12-20 (01 2023) ISSN: 1542-4758 [Electronic] Canada
• PMID: 36203330 (Publication Type: Systematic Review, Journal Article)
• Copyright: © 2022 The Authors. Hemodialysis International published by Wiley Periodicals LLC on behalf of International Society for Hemodialysis.

Chemical References

• Heparin
• Citric Acid
• Citrates

Topics

• Adult
• Humans
• Retrospective Studies
• Central Venous Catheters (adverse effects)
• Renal Dialysis (adverse effects)
• Catheterization (adverse effects)
• Heparin
• Catheter-Related Infections (etiology)
• Citric Acid
• Citrates
• Catheters, Indwelling (adverse effects)
• Observational Studies as Topic