ABSTRACT
Background: Vascular access is a basic and essential tool required for performing renal replacement therapy in end stage renal disease
Aim: To study the indications of tunneled catheter [KTT] in hemodialysis [HD], identify complications related to the use of KTT and contributing factors, assess the survival and performance of the technique
Introduction: The making of a vascular access is an angular piece for adequate HD and in good conditions. In this context the KTT may be an alternative
Methods: A retrospective study of 52 KTT placed in 49 patients collected in the department of Nephrology Dialysis and Renal Transplantation in RABTA Tunis between 2008 and 2011
Results: The average age of our patients was 55.58 years +/- 13.5 years, their Sex ratio was 0.79. The Thirty of our patients were diabetic, 46.2% had hypertension and 21.2% had underlying cardiac disease. The mean duration of HD was 1111.35 days or 37 months. The most common indication of KTT was the absence of arteriovenous fistula in 65.4% of cases, other indications were: short survival [30.7%], the exhaustion of venous capital [34.6%], mediacalcosis [34.6%] and immunosuppression [36.5%]. The right internal jugular vein was the choice of insertion site with 78.8%. The overall incidence of immediate complications was 19.2%. Among our patients, 31.4% had a dysfunction. The period of HD represent the risk factor for dysfunction KTT [p = 0.006].An infectious complication was observed in 29% of cases. The median time to onset of infection was 190.83 days. Staphylococcus was isolated in 40% of cases. The average duration of use of KTT was 238 days. The only single factor determining the survival of KTT was the number of KTT put in the same patient
Conclusion:More than a quarter of the population are dialyzed through a catheter. Despite concerted efforts, much remains to be done for the confection at time of a permanent vascular access