Document Detail


Predictors of failure of catheter salvage in incident hemodialysis patients.
MedLine Citation:
PMID:  23645579     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Purpose: Catheter-related bloodstream infection is a frequent complication for patients who use catheter as dialysis access. This study was performed to identify the risk factors for failed catheter salvage. 
Methods: We enrolled patients who received non-tunneled catheters as initial vascular access during a two-year period. Catheter salvage was attempted in all symptomatically mild patients. Patients were prospectively followed for 8 weeks starting from the day of infection. Risk factors for salvage failure were explored. 
Results: A total of 77 bacteremia episodes occurred in 69 patient, with an infection rate of 1.61 per 1,000 catheter days. Salvage was successful in 73.4% of all episodes. We found that higher ferritin levels (greater vs. lower than 500 mg/l, (odds ratio (OR) 6.388, 95% confidence interval (CI) 2.073, 19.686), higher phosphate levels (greater vs. lower than 5.5 mg/dl, OR 4.084, 95% CI 1.391, 11.978) and shorter time intervals between catheterization and infection (within vs. beyond 3 weeks, OR 4.190, 95% CI 1.279, 13.725) predicted salvage failure. 
Conclusions: Catheter salvage can be a reasonable initial strategy for symptomatically mild patients. We propose salvaging aggressively and waiting watchfully; however, clinical judgment is prior to any specific management protocol.
Authors:
Zhou Zhou; Dongyang Guo; Fan Zhang; Tao Wang; Guangming Zhang; Bin Zhou
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2013-4-1
Journal Detail:
Title:  The International journal of artificial organs     Volume:  -     ISSN:  1724-6040     ISO Abbreviation:  Int J Artif Organs     Publication Date:  2013 Apr 
Date Detail:
Created Date:  2013-5-6     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7802649     Medline TA:  Int J Artif Organs     Country:  -    
Other Details:
Languages:  ENG     Pagination:  0     Citation Subset:  -    
Affiliation:
Department of Nephrology, Chengdu Military General Hospital, Chengdu - China.
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