Re-Evaluating the Protective Effect of Hemodialysis Catheter Locking Solutions in Hemodialysis Patients
Catheter-related bloodstream infections (CRBSIs) and exit-site infections (ESIs) are common complications associated with the use of central venous catheters for hemodialysis. The aim of this study was to analyze the impact of routine locking solutions on the incidence of CRBSI and ESI, in preservin...
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doaj-1d22054c44f049a5bef3da9c3be2c7b02020-11-24T21:49:07ZengMDPI AGJournal of Clinical Medicine2077-03832019-03-018341210.3390/jcm8030412jcm8030412Re-Evaluating the Protective Effect of Hemodialysis Catheter Locking Solutions in Hemodialysis PatientsChang-Hua Chen0Yu-Min Chen1Yu Yang2Yu-Jun Chang3Li-Jhen Lin4Hua-Cheng Yen5Division of Infectious Disease, Department of Internal Medicine, Changhua Christian Hospital, Changhua 500, TaiwanDepartment of Pharmacy, Changhua Christian Hospital, Changhua 500, TaiwanDivision of Nephrology, Department of Internal Medicine, Changhua Christian Hospital, Changhua 500, TaiwanEpidemiology and Biostatistics Center, Changhua Christian Hospital, Changhua 500, TaiwanCenter for Infection Prevention and Control, Changhua Christian Hospital, Changhua 500, TaiwanDepartment of Neurosurgery, Changhua Christian Hospital, Changhua 500, TaiwanCatheter-related bloodstream infections (CRBSIs) and exit-site infections (ESIs) are common complications associated with the use of central venous catheters for hemodialysis. The aim of this study was to analyze the impact of routine locking solutions on the incidence of CRBSI and ESI, in preserving catheter function, and on the rate of all-cause mortality in patients undergoing hemodialysis. We selected publications (from inception until July 2018) with studies comparing locking solutions for hemodialysis catheters used in patients undergoing hemodialysis. A total of 21 eligible studies were included, with a total of 4832 patients and 318,769 days of catheter use. The incidence of CRBSI and ESI was significantly lower in the treated group (citrate-based regimen) than in the controls (heparin-based regimen). No significant difference in preserving catheter function and all-cause mortality was found between the two groups. Our findings demonstrated that routine locking solutions for hemodialysis catheters effectively reduce the incidence of CRBSIs and ESIs, but our findings failed to show a benefit for preserving catheter function and mortality rates. Therefore, further studies are urgently needed to conclusively evaluate the impact of routine locking solutions on preserving catheter function and improving the rates of all-cause mortality.https://www.mdpi.com/2077-0383/8/3/412effectprotectioncatheterhemodialysismeta-analysistrial sequential analysis |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Chang-Hua Chen Yu-Min Chen Yu Yang Yu-Jun Chang Li-Jhen Lin Hua-Cheng Yen |
spellingShingle |
Chang-Hua Chen Yu-Min Chen Yu Yang Yu-Jun Chang Li-Jhen Lin Hua-Cheng Yen Re-Evaluating the Protective Effect of Hemodialysis Catheter Locking Solutions in Hemodialysis Patients Journal of Clinical Medicine effect protection catheter hemodialysis meta-analysis trial sequential analysis |
author_facet |
Chang-Hua Chen Yu-Min Chen Yu Yang Yu-Jun Chang Li-Jhen Lin Hua-Cheng Yen |
author_sort |
Chang-Hua Chen |
title |
Re-Evaluating the Protective Effect of Hemodialysis Catheter Locking Solutions in Hemodialysis Patients |
title_short |
Re-Evaluating the Protective Effect of Hemodialysis Catheter Locking Solutions in Hemodialysis Patients |
title_full |
Re-Evaluating the Protective Effect of Hemodialysis Catheter Locking Solutions in Hemodialysis Patients |
title_fullStr |
Re-Evaluating the Protective Effect of Hemodialysis Catheter Locking Solutions in Hemodialysis Patients |
title_full_unstemmed |
Re-Evaluating the Protective Effect of Hemodialysis Catheter Locking Solutions in Hemodialysis Patients |
title_sort |
re-evaluating the protective effect of hemodialysis catheter locking solutions in hemodialysis patients |
publisher |
MDPI AG |
series |
Journal of Clinical Medicine |
issn |
2077-0383 |
publishDate |
2019-03-01 |
description |
Catheter-related bloodstream infections (CRBSIs) and exit-site infections (ESIs) are common complications associated with the use of central venous catheters for hemodialysis. The aim of this study was to analyze the impact of routine locking solutions on the incidence of CRBSI and ESI, in preserving catheter function, and on the rate of all-cause mortality in patients undergoing hemodialysis. We selected publications (from inception until July 2018) with studies comparing locking solutions for hemodialysis catheters used in patients undergoing hemodialysis. A total of 21 eligible studies were included, with a total of 4832 patients and 318,769 days of catheter use. The incidence of CRBSI and ESI was significantly lower in the treated group (citrate-based regimen) than in the controls (heparin-based regimen). No significant difference in preserving catheter function and all-cause mortality was found between the two groups. Our findings demonstrated that routine locking solutions for hemodialysis catheters effectively reduce the incidence of CRBSIs and ESIs, but our findings failed to show a benefit for preserving catheter function and mortality rates. Therefore, further studies are urgently needed to conclusively evaluate the impact of routine locking solutions on preserving catheter function and improving the rates of all-cause mortality. |
topic |
effect protection catheter hemodialysis meta-analysis trial sequential analysis |
url |
https://www.mdpi.com/2077-0383/8/3/412 |
work_keys_str_mv |
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