Urea-based recirculation validation of the symmetrical palindrome catheter

J Ren Care. 2017 Dec;43(4):242-246. doi: 10.1111/jorc.12210. Epub 2017 Aug 16.

Abstract

Background: High blood flow and low recirculation rates are central for adequate haemodialysis. A new symmetrical tip has been invented promising efficient haemodialysis even if the ports are reversed.

Objective: To evaluate access recirculation of the 'palindrome' catheter and to report initial experiences in a clinical setting.

Material and methods: After implantation of the new catheter in 20 patients (male: 14; female: 6; mean age 72 ± 12.2), access recirculation was evaluated using the urea-based recirculation test. After 30 minutes of haemodialysis, ultrafiltration was stopped and arterial and venous samples were taken. Afterwards, the blood flow rate was reduced to 120 ml/min. Another systemic arterial blood sample was taken 10 seconds after the blood pump was switched off.

Results: All 20 interventions were performed successfully without complications. The average recirculation rate was 8.1% with a median of 2.5% ranging from 0 to 85.8%. Recirculation rates under 5% were measured in 13 patients and more than 10% recirculation were found in two patients. The median of days between catheter implantation and recirculation assessment was the day following implantation.

Conclusion: The new symmetrical catheter presented low recirculation rates in a clinical setting. Since there is just a single tip, fluoroscopic placement in the right atrium is facilitated.

Keywords: Central venous access; Haemodialysis catheter; Palindrome; Urea recirculation.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Central Venous Catheters / adverse effects
  • Central Venous Catheters / standards*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Renal Dialysis / methods*
  • Renal Dialysis / standards
  • Renal Insufficiency, Chronic / therapy
  • Reproducibility of Results
  • Urea / analysis*
  • Urea / blood

Substances

  • Urea