Analysis of influencing factors in tunneled cuffed catheter dysfunction in hemodialysis patients

Objective To retrospectively analyze the influencing factors of tunneled cuffed catheter(TCC) dysfunction in hemodialysis patients.Methods A total of 70 patients,who underwent TCC implantation in Wuhan Hospital of Traditional Chinese and Western Medicine from January 2016 to June 2018 were selected.Their implantation sites were in right internal jugular vein.They received dialysis 3 times every week.According to whether there was catheter dysfunction within 3 months and 12 months,after implantation(if dialysis blood flow was below 200 mL/min,some intervention measures including body position adjustment,inversion of tube connection and thrombolysis),the patients were divided into patent group and blocked group.Their ages,sex,protopathy,body mass index(BMI),location of catheter tip,hemoglobin(Hb),platelet(PLT),albumin(Alb),total cholesterol(TC),triglyceride(TG),fibrinogen(Fib) were collected.By means of comparing variables between patent groups and blocked groups,the primary patency rate of the catheters was calculated,and the influencing factors of catheter dysfunction were identified. Results The primary patency rate of the catheters were 77.1% and 62.9% in 3 and 12 months after implantation.At 3 months after implantation,the primary patency rate with catheter tips in the right atrium(91.2%) were much higher than those with catheter tips in the superior vena cava(42.8%) and pericavoatrial junction(68.9%)(P<0.05).At 12 months,the primary patency rate with catheter tips in the right atrium decreased(79.4%),but was still much higher than those with catheter tips in the superior vena cava(42.8%) and pericavoatrial junction(48.3%)(P<0.05).At 3 and 12 months after implantation,TC and catheter tip position had statistical differences between the patent group and the blocked group(P<0.05).Logistic regression analysis showed that TC and location of catheter tip had independent predictive value for catheter dysfunction at both 3 and 12 months after implantation(P<0.05).Conclusions The main influencing factors of tunneled cuffed catheter dysfunction within 3 and 12 months are higher total cholesterol and abnormal catheter tip position.