Prolonged use of dialysis catheters is associated with elevated chronic inflammatory markers: a single center case series.

BACKGROUND

Long-term tunneled-cuffed dialysis catheters (L-TDCs) are typically considered a temporary solution for vascular access in end-stage kidney disease (ESKD). However, a subset of patients relies on L-TDCs for extended periods. This study aims to characterize these patients and evaluate inflammatory markers.

METHODS

We conducted a retrospective study, cross-sectional of 13 ESKD patients who had an L-TDC in place for at least 12 months at an urban hospital-based dialysis unit. This group was compared to 26 consecutive patients with stable AVFs. Key parameters analyzed included dialysis efficiency (urea reduction ratio, blood flow rates, venous/arterial pressures) and inflammatory markers (C-reactive protein [CRP]).

RESULTS

L-TDCs remained in use for an average of 40.6 ± 27.5 months (range: upto 113 months). Despite similar dialysis efficiency between groups (urea reduction ratio: 72.5% vs. 68.5%,  = 0.07), L-TDC patients exhibited significantly higher CRP levels (19.7 vs. 9.6 mg/L,  = 0.03). Dialysis blood flow rates were lower in the L-TDC group (290.3 vs. 339.4 mL/min,  < 0.0001), with significantly higher venous (193.5 vs. 149.3 mmHg,  = 0.002) and arterial pressures (213.7 vs. 147.5 mmHg,  < 0.0001). A moderate correlation between dialysis vintage and CRP was observed in L-TDC users ( = 0.383,  = 0.17), but not in AVF patients.

CONCLUSION

Although L-TDC users achieve comparable dialysis efficiency to AVF patients, they experience persistent inflammation, as indicated by significantly elevated CRP levels. These findings underscore the need for closer monitoring and strategies to mitigate long-term inflammatory risks in patients requiring prolonged catheter use.