Details

Autor(en) / Beteiligte

• Al-Ali, Fadwa
• Hamdy, Ahmad F
• Hamad, Abdullah
• Elsayed, Mohamed
• Zafar Iqbal, Zafar
• Elsayed, Aisha
• Ibrahim, Rania
• Tolba, Hoda
• Buanan, Hisham
• Fawzy, Ashraf

Titel

Safety and efficacy of taurolidine/urokinase versus taurolidine/heparin as a tunneled catheter lock solution in hemodialysis patients: a prospective, randomized, controlled study

Ist Teil von

• Nephrology, dialysis, transplantation, 2018-04, Vol.33 (4), p.619-626

Ort / Verlag

England

Erscheinungsjahr

2018

Quelle

Oxford Journals 2020 Medicine

Beschreibungen/Notizen

• Taurolidine citrate with heparin (Taurolock/Hep) is a promising central venous catheter lock solution. Despite its universal use among our hemodialysis patients, the prevalence of catheter malfunction was high. We aimed to compare Taurolock/Hep and taurolidine citrate with urokinase (Taurolock/U) as a catheter lock solution in order to identify whether either solution could reduce catheter-related dysfunction. In this prospective, randomized, controlled trial, patients were randomized to receive either Taurolock/Hep or Taurolock/U and were followed for 6 months. Episodes of acute catheter thrombosis, requirement of recombinant tissue plasminogen activator (rt-PA) and incidence of catheter-related blood stream infection (CRBSI) were recorded, along with dialysis adequacy (Kt/V), blood flow rates (BFRs) and adverse events. There were 93 inclusions (85 patients) in the Taurolock/Hep group and 84 inclusions in the Taurolock/U group (79 patients). Three catheters were removed in the Taurolock/Hep group because of acute thrombosis, while no catheter was removed for the same reason in the Taurolock/U group. The total number of all-causes catheter exchange (acute thrombosis and CRBSI) was significantly lower in Taurolock/U group (P = 0.028). rt-PA was used significantly less often in the Taurolock/U group than in the Taurolock/Hep group (P = 0.006). Moreover, higher BFR and Kt/V were noted in the Taurolock/U group than in the Taurolock/Hep group, although the differences were not uniformly significant. Taurolock/U is a safe and effective tunneled dialysis catheter lock solution, with a low rate of catheter exchange.