Li Mingxu, Zhang Zhiyong, Yu Yongwu, Chen Hong, Li Xinxin, Ma Junhong, Dong Zhen
Department of Nephrology, Navy General Hospital, Beijing, China.
Iran J Kidney Dis. 2014 Mar;8(2):123-9.
This study was conducted to compare catheter function, dialysis adequacy, and dialysis-related complications among patients receiving long-term dialysis via Palindrome catheter, Permcath catheter, and arteriovenous fistula (AVF) as vascular access.
Forty-three patients undergoing dialysis with Permcath catheter, 49 with Palindrome catheter, and 56 with AVF were recruited. Urea clearance (KT/V), urea reduction rate, and the highest blood flow at the arteriovenous junction during dialysis were determined during the dialysis sessions. Catheter-related infection, catheter-associated thrombosis, and annual patency rate were also evaluated.
In patients using Permcath catheter for dialysis, the incidence of secondary renal injury (metabolic diseases, hypertension, and ischemic kidney diseases) was 73.1%, which was significantly higher than that in patients with AVF (51.5%; P = .001). In the Palindrome group, maximum blood flow, KT/V, urea reduction rate, and annual patency rate were significantly higher than those in the Permcath group, and the incidence of access-related infection was significantly higher than that in the AVF group. In the Palindrome group, the prevalence of thromboembolism was 30.6%, which was significantly lower than that in the Permcath group (46.5%), but higher than that in the AVF group (5.4%).
For dialysis patients, Palindrome catheter was superior to Permcath catheter and comparable with the AVF in terms of the maximum blood flow, dialysis adequacy, and annual patency rate. Dialysis with Palindrome catheter has a high infection rate and a high incidence of thromboembolism as in the dialysis with Permcath catheter.
本研究旨在比较通过回文导管、Permcath导管和动静脉内瘘(AVF)作为血管通路进行长期透析的患者的导管功能、透析充分性和透析相关并发症。
招募了43例使用Permcath导管进行透析的患者、49例使用回文导管的患者和56例使用AVF的患者。在透析过程中测定尿素清除率(KT/V)、尿素降低率以及透析期间动静脉连接处的最高血流量。还评估了导管相关感染、导管相关血栓形成和年度通畅率。
在使用Permcath导管进行透析的患者中,继发性肾损伤(代谢性疾病、高血压和缺血性肾病)的发生率为73.1%,显著高于使用AVF的患者(51.5%;P = 0.001)。在回文导管组中,最大血流量、KT/V、尿素降低率和年度通畅率显著高于Permcath导管组,且通路相关感染的发生率显著高于AVF组。在回文导管组中,血栓栓塞的患病率为30.6%,显著低于Permcath导管组(46.5%),但高于AVF组(5.4%)。
对于透析患者,在最大血流量、透析充分性和年度通畅率方面,回文导管优于Permcath导管,且与AVF相当。与使用Permcath导管进行透析一样,使用回文导管进行透析具有较高的感染率和血栓栓塞发生率。