DOI QR코드

DOI QR Code

Comparison of treatment delay associated with tunneled hemodialysis catheter placement between interventionists

  • Kim, Yoo Hyung (Division of Nephrology, Department of Internal Medicine, Chungnam National University Hospital) ;
  • Kim, Hae Ri (Division of Nephrology, Department of Internal Medicine, Chungnam National University Hospital) ;
  • Jeon, Hong Jae (Division of Nephrology, Department of Internal Medicine, Chungnam National University Hospital) ;
  • Kim, Ye-Jin (Division of Nephrology, Department of Internal Medicine, Chungnam National University Hospital) ;
  • Jung, Sa Ra (Division of Nephrology, Department of Internal Medicine, Chungnam National University Hospital) ;
  • Choi, Dae Eun (Division of Nephrology, Department of Internal Medicine, Chungnam National University Hospital) ;
  • Lee, Kang Wook (Division of Nephrology, Department of Internal Medicine, Chungnam National University Hospital) ;
  • Na, Ki Ryang (Division of Nephrology, Department of Internal Medicine, Chungnam National University Hospital)
  • Received : 2014.12.10
  • Accepted : 2015.01.09
  • Published : 2016.05.01

Abstract

Background/Aims: Fragmented care in nephrology can cause treatment delays. Nephrologists are qualified to perform vascular access-related procedures because they understand the pathophysiology of renal disease and perform physical examination for vascular access. We compared treatment delays associated with tunneled hemodialysis catheter (TDC) placement between interventional radiologists and nephrologists. Methods: We collected data by radiologists from January 1, 2011 through December 31, 2011 and by nephrologists from since July 1, 2012 through June 30, 2013. We compared the duration from the hemodialysis decision to TDC placement (D-P duration) and hemodialysis initiation (D-H duration), catheter success and the complication rate, and the frequency and the usage time of non-tunneled hemodialysis catheters (NDCs) before TDC placement. Results: The study analyzed 483 placed TDCs: 280 TDCs placed by radiologists and 203 by nephrologists. The D-P durations were 319 minutes (interquartile range [IQR], 180 to 1,057) in the radiologist group and 140 minutes (IQR, 0 to 792) in the nephrologist group. Additionally, the D-H durations were 415 minutes (IQR,260 to 1,091) and 275 minutes (IQR, 123 to 598), respectively. These differences were statistically significant (p = 0.00). The TDC success rate (95.3% vs. 94.5%, respectively; p = 0.32) and complication rate (16.2% vs. 11%, respectively; p = 0.11) did not differ between the groups. The frequency (24.5 vs. 26%, respectively; p = 0.72) and the usage time of NDC (8,451 vs. 8,416 minutes, respectively; p = 0.91) before TDC placement were not statistically significant. Conclusions: Trained interventional nephrologists could perform TDC placement safely, minimizing treatment delays.

Keywords

References

  1. Lund GB, Trerotola SO, Scheel PF Jr, et al. Outcome of tunneled hemodialysis catheters placed by radiologists. Radiology 1996;198:467-472. https://doi.org/10.1148/radiology.198.2.8596851
  2. Trerotola SO, Johnson MS, Harris VJ, et al. Outcome of tunneled hemodialysis catheters placed via the right internal jugular vein by interventional radiologists. Radiology 1997;203:489-495. https://doi.org/10.1148/radiology.203.2.9114110
  3. Asif A, Byers P, Vieira CF, Preston RA, Roth D. Diagnostic and interventional nephrology. Am J Ther 2002;9:530-536. https://doi.org/10.1097/00045391-200211000-00014
  4. Jackson JW, Lewis JL, Brouillette JR, Brantley RR Jr. Initial experience of a nephrologist-operated vascular access center. Semin Dial 2000;13:354-358.
  5. Asif A, Besarab A, Roy-Chaudhury P, Spergel LM, Ravani P. Interventional nephrology: from episodic to coordinated vascular access care. J Nephrol 2007;20:399-405.
  6. Moss AH, McLaughlin MM, Lempert KD, Holley JL. Use of a silicone catheter with a Dacron cuff for dialysis short-term vascular access. Am J Kidney Dis 1988;12:492-498. https://doi.org/10.1016/S0272-6386(88)80100-8
  7. Moss AH, Vasilakis C, Holley JL, Foulks CJ, Pillai K, Mc-Dowell DE. Use of a silicone dual-lumen catheter with a Dacron cuff as a long-term vascular access for hemodialysis patients. Am J Kidney Dis 1990;16:211-215. https://doi.org/10.1016/S0272-6386(12)81020-1
  8. Schwab SJ, Buller GL, McCann RL, Bollinger RR, Stickel DL. Prospective evaluation of a Dacron cuffed hemodialysis catheter for prolonged use. Am J Kidney Dis 1988;11:166-169. https://doi.org/10.1016/S0272-6386(88)80206-3
  9. Lok CE. Fistula first initiative: advantages and pitfalls. Clin J Am Soc Nephrol 2007;2:1043-1053. https://doi.org/10.2215/CJN.01080307
  10. Ackad A, Simonian GT, Steel K, et al. A journey in reversing practice patterns: a multidisciplinary experience in implementing DOQI guidelines for vascular access. Nephrol Dial Transplant 2005;20:1450-1455. https://doi.org/10.1093/ndt/gfh818
  11. Wasse H, Speckman RA, Frankenfield DL, Rocco MV, McClellan WM. Predictors of delayed transition from central venous catheter use to permanent vascular access among ESRD patients. Am J Kidney Dis 2007;49:276-283. https://doi.org/10.1053/j.ajkd.2006.11.030
  12. Moist LM, Trpeski L, Na Y, Lok CE. Increased hemodialysis catheter use in Canada and associated mortality risk: data from the Canadian Organ Replacement Registry 2001-2004. Clin J Am Soc Nephrol 2008;3:1726-1732. https://doi.org/10.2215/CJN.01240308
  13. Rayner HC, Besarab A, Brown WW, Disney A, Saito A, Pisoni RL. Vascular access results from the Dialysis Outcomes and Practice Patterns Study (DOPPS): performance against Kidney Disease Outcomes Quality Initiative (K/DOQI) Clinical Practice Guidelines. Am J Kidney Dis 2004;44(5 Suppl 2):22-26. https://doi.org/10.1016/S0272-6386(04)01101-1
  14. Astor BC, Eustace JA, Powe NR, et al. Type of vascular access and survival among incident hemodialysis patients: the Choices for Healthy Outcomes in Caring for ESRD (CHOICE) Study. J Am Soc Nephrol 2005;16:1449-1455. https://doi.org/10.1681/ASN.2004090748
  15. Dhingra RK, Young EW, Hulbert-Shearon TE, Leavey SF, Port FK. Type of vascular access and mortality in U.S. hemodialysis patients. Kidney Int 2001;60:1443-1451. https://doi.org/10.1046/j.1523-1755.2001.00947.x
  16. Polkinghorne KR, McDonald SP, Atkins RC, Kerr PG. Vascular access and all-cause mortality: a propensity score analysis. J Am Soc Nephrol 2004;15:477-486. https://doi.org/10.1097/01.ASN.0000109668.05157.05
  17. Vesely TM, Beathard G, Ash S, Hoggard J, Schon D; ASDIN Clinical Practice Committee. A position statement from the American Society of Diagnostic and Interventional Nephrology. Semin Dial 2007;20:359-364. https://doi.org/10.1111/j.1525-139X.2007.00318.x
  18. Beathard GA, Litchfield T; Physician Operators Forum of RMS Lifeline, Inc. Effectiveness and safety of dialysis vascular access procedures performed by interventional nephrologists. Kidney Int 2004;66:1622-1632. https://doi.org/10.1111/j.1523-1755.2004.00928.x
  19. Cimochowski GE, Worley E, Rutherford WE, Sartain J, Blondin J, Harter H. Superiority of the internal jugular over the subclavian access for temporary dialysis. Nephron 1990;54:154-161. https://doi.org/10.1159/000185837
  20. Schillinger F, Schillinger D, Montagnac R, Milcent T. Post-catheterization venous stenosis in hemodialysis: comparative angiographic study of 50 subclavian and 50 internal jugular accesses. Nephrologie 1992;13:127-133.
  21. Vanholder R, Ringoir S. Vascular access for hemodialysis. Artif Organs 1994;18:263-265. https://doi.org/10.1111/j.1525-1594.1994.tb02192.x
  22. Develter W, De Cubber A, Van Biesen W, Vanholder R, Lameire N. Survival and complications of indwelling venous catheters for permanent use in hemodialysis patients. Artif Organs 2005;29:399-405. https://doi.org/10.1111/j.1525-1594.2005.29067.x
  23. Kakkos SK, Haddad GK, Haddad RK, Scully MM. Effectiveness of a new tunneled catheter in preventing catheter malfunction: a comparative study. J Vasc Interv Radiol 2008;19:1018-1026. https://doi.org/10.1016/j.jvir.2008.03.006
  24. Hwang HS, Kang SH, Choi SR, Sun IO, Park HS, Kim Y. Comparison of the palindrome vs. step-tip tunneled hemodialysis catheter: a prospective randomized trial. Semin Dial 2012;25:587-591. https://doi.org/10.1111/j.1525-139X.2012.01054.x
  25. Tal MG. Comparison of recirculation percentage of the palindrome catheter and standard hemodialysis catheters in a swine model. J Vasc Interv Radiol 2005;16:1237-1240. https://doi.org/10.1097/01.RVI.0000171700.45582.9E