›› 2011, Vol. 10 ›› Issue (10): 535-537.doi: R318.16 R512.6

• 临床研究 • Previous Articles     Next Articles

The influence of systemic anticoagulation with warfarin between dialysis sessions on survival in hemodialysis patients with long-term indwelling catheters

LONG Chun-jiao, LI Yuan-ming, SUN Yong-chao, WANG Lu-fang, PENG Lan, XIE Hui-le, WU Kun   

  1. Blood Hemodialysis Center, the Third Xiangya Hospital, Central South University, Changsha 410013, China
  • Received:2011-07-05 Revised:1900-01-01 Online:2011-10-12 Published:2011-10-12

Abstract:

Objective Long-term indwelling catheter is an alternative approach for vascular access in hemodialysis patients. However, complications such as thromboses and infections often lead to catheter dysfunction. To investigate the effect of anticoagulation on catheter patency, we used warfarin between dialysis sessions in hemodialysis patients with tunneled, cuffed and indwelling catheters in right internal jugular vein. Method In a cohort of 309 hemodialysis patients implanted with cuffed dual-lumen catheters in right jugular vein as vascular access, 144 patients took adjusted doses of warfarin between dialysis sessions, and the remaining 165 cases without anticoagulation medication were served as controls. Catheter patency and infection rate were monitored. The study end point arrived when their blood flow during a dialysis session became <200ml/min, they had refractory catheter infection, or their observation period reached to 36 months. Results The average survival period of catheter was significantly longer in anticoagulant group than in control group (31.8±0.9 months vs. 22.0±1.2 months, P<0.01). Moreover, patients in anticoagulant group had a higher 3-year patency rate (82.6% vs 51.5%, P = 0.003) and a lower catheter infection rate (5.6% vs 14.5%, P<0.05). Conclusion Warfarin is effective in extending catheter patency period and lowering local infection rate.

Key words: Long-term catheter, Anticoagulation, Thrombosis, Infection, Patency rate