Natural saline-flush is sufficient to maintain patency of immobilized-urokinase double-lumen catheter used to provide temporary blood access for hemodialysis

Blood Purif. 2004;22(5):473-9. doi: 10.1159/000081811. Epub 2004 Oct 29.

Abstract

Background: Thrombotic occlusion is a frequent complication of central venous catheters used to provide temporary blood access on hemodialysis therapy. Heparin-lock is conventionally used to maintain patency of the catheter, but the necessity of heparin-lock has not been determined yet.

Methods: After the immobilized-urokinase double-lumen central venous catheter was inserted into 48 Japanese hemodialysis patients, 22 patients randomized to the heparin group received a 20-ml saline-flush, followed by 2 ml of 1,000 U/ml heparin-lock, and 26 patients randomized to the saline group received only the 20-ml saline-flush once a day for each lumen.

Results: Thrombotic occlusion was observed in only 1 out of 22 patients in the heparin group and 1 out of 26 patients in the saline group. No significant difference of the catheter survival was observed between the two groups (p = 0.8599).

Conclusions: Natural saline-flush is sufficient for maintaining the patency of an immobilized-urokinase double-lumen central venous catheter.

Publication types

  • Clinical Trial
  • Comparative Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Blood Coagulation / drug effects
  • Catheterization / standards*
  • Enzymes, Immobilized
  • Equipment Failure
  • Female
  • Heparin / therapeutic use
  • Humans
  • Kidney Failure, Chronic / therapy
  • Male
  • Middle Aged
  • Renal Dialysis / instrumentation*
  • Renal Dialysis / methods
  • Sodium Chloride / pharmacology*
  • Treatment Outcome
  • Urokinase-Type Plasminogen Activator / therapeutic use*

Substances

  • Enzymes, Immobilized
  • Sodium Chloride
  • Heparin
  • Urokinase-Type Plasminogen Activator