Is central venous catheter in haemodialysis still the main factor of mortality after hospitalization?

BMC Nephrol. 2024 Mar 8;25(1):90. doi: 10.1186/s12882-023-03433-6.

Abstract

Background: Haemodialysis is the most frequently prescribed Renal Replacement Therapy modality worldwide. However, patients undergoing this therapy have an unpredictable evolution related to vascular access.

Objective: To determine the factors associated with the mortality and hospitalization rate in haemodialysis patients at a third-level care Centre in the Dominican Republic.

Methods: This was an observational and prospective study involving a cohort of 192 haemodialysis patients. The patient selection was non-probabilistic for convenience, and a direct source questionnaire was applied.

Results: Of the 192 patients in the cohort, 103 (53.6%) were hospitalized and evaluated. The most frequent cause of hospitalization was catheter-related bloodstream infections (53.4%). Almost one-third (28.2%) of the hospitalized patients died, mostly due to infections (12.6%). Of those who died 29 patients (90%) had a Central venous catheter (CVC) with a non-tunnelled catheter (NTCVC) (65.5%); having an NTC CVC makes a patient 85.5 times more likely to be hospitalized than patients with arteriovenous fistulas.

Conclusion: Vascular access plays a predominant role in the hospitalization and mortality rates in haemodialysis. Patients with an arteriovenous fistula obtained significantly better outcomes than those with central venous catheters.

Keywords: Chronic Kidney Disease; Comparison CVC versus AVF; Haemodialysis; Hospitalization rate; Mortality rate; Vascular Access.

Publication types

  • Observational Study

MeSH terms

  • Arteriovenous Shunt, Surgical* / adverse effects
  • Central Venous Catheters* / adverse effects
  • Hospitalization
  • Humans
  • Patient Selection
  • Prospective Studies
  • Renal Dialysis / adverse effects