Balancing Thrombosis and Infection Risks

Introduction

The duration of no-tunneled hemodialysis catheters (NTHCs) significantly influences patient outcomes, particularly regarding thrombosis and infection risks. This study, published in the Journal of Clinical Nephrology, investigates the ideal residence time for temporary central venous catheters (CVCs) and its impact on complications.

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Key Findings

Thrombosis Risk Increases with Time: The study identified a 14-day cut-off after which thrombosis risk significantly rises.
Infection Rates Not Directly Correlated with Time: Unlike thrombosis, infection rates were not significantly linked to catheter duration.
Insertion Site Matters: Lower-site CVCs (femoral) had a higher incidence of thrombosis compared to upper-site (jugular) catheters.

Clinical Implications

• CVC Replacement Strategy: Patients with femoral NTHCs should be closely monitored, and catheter changes should be considered after 14 days to minimize thrombosis risk.
• KDOQI Guidelines Compliance: Findings support the 2019 KDOQI recommendation of limiting non-tunneled CVCs to short-term use.

Read the full study here: https://doi.org/10.29328/journal.jcn.1001122

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