Tamer Sakaci*, Baris Doner, Tuncay Sahutoglu, Ekrem Kara, Elbis Ahbap, Taner Basturk, Emrah Erkan Mazı, Cuneyt Akgol and Abdulkadir Unsal
Objective: This study aimed to investigate the impact of catheter lock solutions in hemodialysis catheters on colonization and explore other factors influencing colonization.
Methods: A total of 73 consecutive patients were prospectively included in the study. Demographic data, etiology, catheter insertion site, number of hemodialysis sessions, duration of catheter use, and history of coronary artery disease, anticoagulant, and antilipidemic drug usage were recorded. Nasal cultures were obtained, and patients were divided into two groups based on the catheter lock solutions used: heparin and 30% trisodium citrate. The frequency of colonization, culture results, and factors affecting colonization were compared between the two solution groups.
Results: A total of 67 catheters were inserted in 59 patients. The mean follow-up duration was 25.4 ± 27.02 (7-113) days, and the mean number of hemodialysis sessions was 10.9 ± 10.8 (2-46) times. Thirty-two catheters in 29 patients were closed with heparin, while 35 catheters in 30 patients were closed with citrate. The heparin group had a longer catheter duration and a higher number of dialysis sessions compared to the citrate group (p<0.005 for both). The presence of systemic infections and nasal carriage was similar between the two groups (p>0.005 for both). The culture positivity rate was 34% in the heparin group and 23% in the citrate group (p: 0.46). The infection rate was higher in jugular catheters closed with heparin and femoral catheters closed with citrate. A significant correlation was observed between catheter tip colonization and a history of infection in the heparin group (r: 0.405, p: 0.02), and between colonization and catheter localization in the citrate group (r: 0.440, p: 0.008).
Conclusion: Catheter lock solutions did not have a significant effect on the frequency of catheter colonization. The site of catheter insertion, duration of catheter use, and systemic infectious status were identified as factors influencing catheter colonization in temporary hemodialysis catheters.
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