The best solution down the line: an observational study on taurolidine- versus citrate-based lock solutions for central venous catheters in hemodialysis patients
Abstract Introduction To prevent infection and thrombosis of central venous catheters (CVCs) in hemodialysis patients, different CVC lock solutions are available. Taurolidine-based solutions and citrate in different concentrations are frequently used, but no definite conclusions with regard to super...
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doaj-beff94fc76c54be88ddd53c465be7c322021-09-19T11:58:44ZengBMCBMC Nephrology1471-23692021-09-012211810.1186/s12882-021-02519-3The best solution down the line: an observational study on taurolidine- versus citrate-based lock solutions for central venous catheters in hemodialysis patientsSonja van Roeden0Mathijs van Oevelen1Alferso C. Abrahams2Friedo W. Dekker3Joris I. Rotmans4Sabine C. A. Meijvis5on behalf of the DUCATHO study groupDepartment of Nephrology and Hypertension, University Medical Center UtrechtDepartment of Internal Medicine, Leiden University Medical CenterDepartment of Nephrology and Hypertension, University Medical Center UtrechtDepartment of Clinical Epidemiology, Leiden University Medical CenterDepartment of Internal Medicine, Leiden University Medical CenterDepartment of Nephrology and Hypertension, University Medical Center UtrechtAbstract Introduction To prevent infection and thrombosis of central venous catheters (CVCs) in hemodialysis patients, different CVC lock solutions are available. Taurolidine-based solutions and citrate in different concentrations are frequently used, but no definite conclusions with regard to superiority have been drawn. Methods In this retrospective, observational, multicenter study, we aimed to assess the risk for removal of CVC due to infection or catheter malfunction in hemodialysis patients with CVC access for different lock solutions: taurolidine, high-concentrated citrate (46.7%) and low-concentrated citrate (4 or 30%). A multivariable Cox-regression model was used to calculate hazard ratio’s (HR). Results We identified 1514 patients (median age 65 years, 59% male). In 96 (6%) taurolidine-based lock solutions were used. In 1418 (94%) citrate-based lock solutions were used (high-concentrated 73%, low-concentrated 20%). Taurolidine-based lock solutions were associated with a significantly lower hazard for removal of CVC due to infection or malfunction combined (HR 0.34, 95% CI 0.19–0.64), and for removal of CVC due to infection or malfunction separately (HR 0.36, 95% CI 0.15–0.88 and HR0.33, 95% CI 0.14–0.79). High-concentrated citrate lock solutions were not associated with a decreased hazard for our outcomes, compared to low-concentrated citrate lock solutions. Conclusion Removal of CVC due to infection or catheter malfunction occurred less often with taurolidine-based lock solutions. We present the largest cohort comparing taurolidine- and citrate-based lock solutions yet. However, due to the retrospective observational nature of this study, conclusions with regard to superiority should be drawn with caution.https://doi.org/10.1186/s12882-021-02519-3Central venous catheterHemodialysisLockLock solution |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Sonja van Roeden Mathijs van Oevelen Alferso C. Abrahams Friedo W. Dekker Joris I. Rotmans Sabine C. A. Meijvis on behalf of the DUCATHO study group |
spellingShingle |
Sonja van Roeden Mathijs van Oevelen Alferso C. Abrahams Friedo W. Dekker Joris I. Rotmans Sabine C. A. Meijvis on behalf of the DUCATHO study group The best solution down the line: an observational study on taurolidine- versus citrate-based lock solutions for central venous catheters in hemodialysis patients BMC Nephrology Central venous catheter Hemodialysis Lock Lock solution |
author_facet |
Sonja van Roeden Mathijs van Oevelen Alferso C. Abrahams Friedo W. Dekker Joris I. Rotmans Sabine C. A. Meijvis on behalf of the DUCATHO study group |
author_sort |
Sonja van Roeden |
title |
The best solution down the line: an observational study on taurolidine- versus citrate-based lock solutions for central venous catheters in hemodialysis patients |
title_short |
The best solution down the line: an observational study on taurolidine- versus citrate-based lock solutions for central venous catheters in hemodialysis patients |
title_full |
The best solution down the line: an observational study on taurolidine- versus citrate-based lock solutions for central venous catheters in hemodialysis patients |
title_fullStr |
The best solution down the line: an observational study on taurolidine- versus citrate-based lock solutions for central venous catheters in hemodialysis patients |
title_full_unstemmed |
The best solution down the line: an observational study on taurolidine- versus citrate-based lock solutions for central venous catheters in hemodialysis patients |
title_sort |
best solution down the line: an observational study on taurolidine- versus citrate-based lock solutions for central venous catheters in hemodialysis patients |
publisher |
BMC |
series |
BMC Nephrology |
issn |
1471-2369 |
publishDate |
2021-09-01 |
description |
Abstract Introduction To prevent infection and thrombosis of central venous catheters (CVCs) in hemodialysis patients, different CVC lock solutions are available. Taurolidine-based solutions and citrate in different concentrations are frequently used, but no definite conclusions with regard to superiority have been drawn. Methods In this retrospective, observational, multicenter study, we aimed to assess the risk for removal of CVC due to infection or catheter malfunction in hemodialysis patients with CVC access for different lock solutions: taurolidine, high-concentrated citrate (46.7%) and low-concentrated citrate (4 or 30%). A multivariable Cox-regression model was used to calculate hazard ratio’s (HR). Results We identified 1514 patients (median age 65 years, 59% male). In 96 (6%) taurolidine-based lock solutions were used. In 1418 (94%) citrate-based lock solutions were used (high-concentrated 73%, low-concentrated 20%). Taurolidine-based lock solutions were associated with a significantly lower hazard for removal of CVC due to infection or malfunction combined (HR 0.34, 95% CI 0.19–0.64), and for removal of CVC due to infection or malfunction separately (HR 0.36, 95% CI 0.15–0.88 and HR0.33, 95% CI 0.14–0.79). High-concentrated citrate lock solutions were not associated with a decreased hazard for our outcomes, compared to low-concentrated citrate lock solutions. Conclusion Removal of CVC due to infection or catheter malfunction occurred less often with taurolidine-based lock solutions. We present the largest cohort comparing taurolidine- and citrate-based lock solutions yet. However, due to the retrospective observational nature of this study, conclusions with regard to superiority should be drawn with caution. |
topic |
Central venous catheter Hemodialysis Lock Lock solution |
url |
https://doi.org/10.1186/s12882-021-02519-3 |
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