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Approaches to Prolong the Use of Uncuffed Hemodialysis Catheters: Results of a Randomized Trial.
MedLine Citation:
PMID:  21372561     Owner:  NLM     Status:  Publisher    
Background: Use of uncuffed catheters (UCs) in hemodialysis patients is common practice. An antibiotic lock has been recommended to prevent catheter-related bacteremia (CRB), although insufficient data are available about the appropriate antimicrobial agent and dose with prolonged use of UCs. Methods: This open-label randomized study was conducted to compare gentamicin/heparin (group A) and taurolidine/citrate (group B), as catheter-lock solutions, in 119 chronic hemodialysis patients in whom a total of 150 UCs were placed. A well-matched historical control group (heparin) included 67 UCs in 58 patients (group C). Results: CRB episodes developed in 6 and 8 patients in groups A and B, respectively, significantly fewer than in group C (20 patients). Cumulative CRB-free catheter survival at 90 days was 82% for A and 78% for B, which is significantly higher than the 26% for C. Similar Gram-positive infection rates were found in all groups. The Gram-negative infection rate was significantly lower in B compared to C. No significant differences in thrombosis rates were observed between the groups. Conclusions: Gentamicin/heparin and taurolidine/citrate, used for locking UC, were similarly effective at preventing CRB and catheter thrombosis for up to 3 months, until a functional permanent vascular access became available. Both antimicrobial lock solutions were superior to heparin in CRB prevention with similar thrombosis rates.
Vassilis Filiopoulos; Dimitrios Hadjiyannakos; Ioannis Koutis; Sofia Trompouki; Theodora Micha; Dimitrios Lazarou; Dimosthenis Vlassopoulos
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-3-02
Journal Detail:
Title:  American journal of nephrology     Volume:  33     ISSN:  1421-9670     ISO Abbreviation:  -     Publication Date:  2011 Mar 
Date Detail:
Created Date:  2011-3-4     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8109361     Medline TA:  Am J Nephrol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  260-268     Citation Subset:  -    
Copyright Information:
Copyright © 2011 S. Karger AG, Basel.
Department of Nephrology, Amalia Fleming General Hospital, Athens, Greece.
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