Hemodialysis access complications during the first 30 days in Libyan patients: a single center experience
Keywords:
Hemo dialysis catheter, double lumen catheter blockage, catheter infection, septicemia, libyaAbstract
Temporary hemodialysis (HD) catheter is required mostly in acute and chronic renal failure and other cases. HD catheter is not free of complications. Thus, the aim of this study is to assess the common complications occur during HD-catheter insertion and during the first 30-days of insertion. Methods: two hundred-ten patients had temporary HD catheter been inserted in Central Hospital (Tripoli) and in near other private clinics. Patients had questionnaire that prepared about the complications. They were divided into three groups according to the site of HD catheter insertion at presentation. The complications detected by patients and/or following up doctors reported in the same questionnaire. Data was collected at the end of 30 days after HD-catheter insertion and analyzed for demographic patients feature, and the complications reported at insertion and during the first 30 days. Results: Randomly allocated patients as they were presented. Group A: 95 patients had catheter at the jugular veins. Group B: 73 patients had femoral vein canalization and group C: 42 patients had subclavian vein catheterization. Pain at the site of insertion and during the first 12 hours was common complications (72.9%) and pain around the insertion site reported by 48.6% patients. Infection at the site of insertion reported in 38.6% of patients. Femoral vein catheterization entrance site infection was reported in 55.6%, at subclavian in 18.5% and at jugular veins in25.9% patients. Catheter tunnel infection was reported in 5.2% patients. Catheter tunnel infection was more with femoral catheter. Arterial or venous HD catheter lumen blockage reported in 21.9%. Two lumens blockage reported in 61 29% patients. Bleeding from the entrance site of the catheter reported during HD sessions reported in 4.8% patients. Hematoma at insertion site or around it was reported in 24.8% patients. It was more after femoral vein catheterization (53.8%) followed by jugular (34.6%) then subclavian catheterization (11.5%) patients. In conclusion, pain and infection at the insertion site were the commonest complications of HD catheter insertion. Reducing rate of these complications depends mainly upon implanting strict septic techniques, and train doctors and nurses about HD insertion complications and care.
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