Temporary Catheters as a Permanent Vascular Access in Very Elderly Hemodialysis Patients: Frequency of Complications and Interventions

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Abstract

The choice of vascular access in very elderly hemodialysis patients can be complex. Data on the frequency of interventions and complications when temporary catheters are used for long periods in this population are lacking. All incident patients ≥80 years old, dialyzed over non-tunneled catheters, were included and the frequency of interventions (re-insertions and wire-exchanges) and complications (catheter-related blood stream infections) were recorded. In 31 patients aged 84 ± 4 years, dialyzed for 1.4 ± 1.1 years, 87 interventions were needed (2.02/patient-year). The median time to first intervention was 5.5 months and the 1-year intervention-free rate was 32%. There were three catheter-related blood stream infections (0.2/1000 access-days), comparing favorably to tunneled catheters. To conclude, temporary catheters are associated with a low rate of complications and an acceptable rate of interventions. Therefore, they could be the optimal vascular access in very elderly patients when the placement of an arterio-venous fistula is not feasible.

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