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Taurolidine-based catheter lock regimen significantly reduces overall costs, infection, and dysfunction rates of tunneled hemodialysis catheters
- Source :
- Kidney International. 93:753-760
- Publication Year :
- 2018
- Publisher :
- Elsevier BV, 2018.
-
Abstract
- Catheter-related infections and dysfunction are the main catheter complications causing morbidity and mortality in hemodialysis patients. However, there are no consistent data for the choice of catheter lock solutions for tunneled hemodialysis lines. In this prospective, multicenter, randomized, controlled trial, two lock regimens using three commercial catheter lock solutions were compared in 106 hemodialysis patients with a newly inserted tunneled central catheter. In the taurolidine group, TauroLock™-Hep500 was used twice per week and TauroLock™-U25,000 once a week. In the citrate group, a four percent citrate solution was used after each dialysis. Both groups were compared regarding catheter-related infections, catheter dysfunction, and costs. Over a period of 15,690 catheter days, six catheter-related infections occurred in six of 52 patients in the taurolidine group, but 18 occurred in 13 of 54 patients in the citrate group, corresponding to 0.67 and 2.7 episodes of catheter-related infections per 1000 catheter days, respectively (Incidence Rate Ratio 0.25, 95% confidence interval, 0.09 to 0.63). Catheter dysfunction rates were significantly lower in the taurolidine group (18.7 vs. 44.3/1000 catheter days) and alteplase rescue significantly more frequent in the citrate group (9.8 vs. 3.8/1000 catheter days). These differences provided significant catheter-related cost savings of 43% in the taurolidine group vs. citrate group when overall expenses per patient and year were compared. Thus, use of taurolidine-based catheter lock solutions containing heparin and urokinase significantly reduced complications related to tunneled hemodialysis catheters when compared to four percent citrate solution and was overall more cost-efficient.
- Subjects :
- Urokinase
medicine.medical_specialty
business.industry
medicine.medical_treatment
030232 urology & nephrology
Hemodialysis Catheter
Taurolidine
law.invention
Surgery
03 medical and health sciences
Regimen
Catheter
chemistry.chemical_compound
0302 clinical medicine
Randomized controlled trial
chemistry
Nephrology
law
Anesthesia
medicine
030212 general & internal medicine
Hemodialysis
business
Dialysis
medicine.drug
Subjects
Details
- ISSN :
- 00852538
- Volume :
- 93
- Database :
- OpenAIRE
- Journal :
- Kidney International
- Accession number :
- edsair.doi...........7f2d939c2cc6c8b8b1a387f17436916c