Does Prophylactic Anticoagulation Reduce the Risk of Femoral Tunneled Dialysis Catheter-related Complications?:

PurposeTo determine the incidence and predictors of femoral tunneled dialysis catheter (TDC)-related complications and whether prophylactic anticoagulation is associated with reduced catheter-related deep vein thrombosis (CRT) or prolonged patency.MethodsA retrospective review of femoral TDCs inserted for maintenance hemodialysis in patients from two dialysis units that have used two different strategies to reduce thrombotic complications. One center routinely considered all femoral TDCs for prophylactic anticoagulation, whilst the other restricted anticoagulation to TDCs that had required repeated treatment with urokinase locks to maintain patency. Survival analyses were performed to establish complication rates, identify predictors of complications and assess the effect of prophylactic anticoagulation use.ResultsOf the 194 femoral TDCs identified, 178 (92%) were associated with at least one complication. Approximately three quarters did not provide adequate small solute clearance; one half were not in u...