A multicenter, prospective, randomized, comparative evaluation of dual- versus triple-lumen catheters for hemodialysis and apheresis in 485 patients

Gabriel Contreras, Ping Yu Liu, Lawrence Elzinga, Michael S. Anger, Jean Lee, Nurian Robert, Robert Chvala, Ronald L. Mars, Thomas Vesely, Tim E. Taber, Douglas Shemin, Randy Shafritz, Joseph Pulliam

Research output: Contribution to journalArticlepeer-review

13 Scopus citations

Abstract

Background: The purpose of this study is to compare a new temporary triple-lumen catheter (TLC) for dialysis that has a third lumen devoted to fluid and medication administration or blood sampling with a marketed dual-lumen catheter (DLC). Methods: Four hundred eighty-five patients referred for acute hemodialysis or apheresis were randomly assigned to either a TLC or DLC in a multicenter, prospective, randomized trial. Results: Analysis of blood flow rates was completed on 464 patients (228 patients, DLC; 236 patients, TLC) with a total of 1,681 hemodialysis (808 treatments, DLC; 873 treatments, TLC) and 82 apheresis treatments (37 treatments, DLC; 45 treatments, TLC). During hemodialysis, a median achieved flow rate (AFR) of 267 mL/min was realized for both groups (P = 0.58). During apheresis, a median AFR of 72.5 mL/min (range, 50 to 150 mL/min) was achieved in the DLC group, and 87 mL/min (range, 60 to 150 mL/min), in the TLC group (P = 0.14). Three hundred ninety-three patients (193 patients, DLC; 200 patients, TLC) had blood and catheter tip cultures performed on removal, and catheter-related blood-stream infection (CRBSI) status was determined. Thirty-one patients (7.9%) had a CRBSI: 16 patients (8.3%), DLC; and 15 patients (7.5%), TLC (P= 0.77). Incidence densities of CRBSI were 12.4/1,000 DLC-days and 10.2/1,000 TLC-days (P = 0.59). The CRBSI incidence of 18.2/1,000 catheter-days for femoral sites was significantly greater than the 7/1,000 catheter-days for jugular sites (P = 0.02) and 6.6/1,000 catheter-days for combined jugular and subclavian sites (P = 0.01). In multivariate analysis, antibiotic use was the only factor related to CRBSI (odds ratio, 0.30; 95% confidence interval, 0.12 to 0.76). There were no statistically significant differences in rates of other complications between the 2 catheters. Conclusion: Results show that the new TLC is similar to the marketed DLC.

Original languageEnglish (US)
Pages (from-to)315-324
Number of pages10
JournalAmerican Journal of Kidney Diseases
Volume42
Issue number2
DOIs
StatePublished - Aug 1 2003
Externally publishedYes

Keywords

  • Apheresis
  • Hemodialysis (HD)
  • Randomized clinical trial
  • Temporary triple-lumen catheter (TLC)

ASJC Scopus subject areas

  • Nephrology

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