Abstract: Context: Tunneled cuffed catheters (TCCs) are vital haemodialysis access devices in chronic kidney disease (CKD), yet prone to significant dysfunction-related morbidity. Aims: To identify bedside patient-related predictors of TCC dysfunction and reduced patency in adult CKD patients undergoing haemodialysis at a single Indonesian center. Settings and Design: Single-center retrospective cohort study at Rasyida Kidney Hospital, Medan, Indonesia, covering TCC insertions from 2021 to 2024. Methods and Material: Primary outcomes were catheter dysfunction and patency. Variables were extracted from medical records. Statistical analysis used: Multivariable logistic regression identified predictors of dysfunction; Cox proportional hazards regression assessed reduced patency. Results: A total of 102 TCCs in 96 adult patients were included. Mean age was 62.7 ± 14.9 years and 62.7% were female. Dysfunction occurred in 30 catheters (29.4%) over a mean dwell time of 20.1 ± 13.1 months. Independent predictors of dysfunction were femoral insertion site (aOR 3.56, 95% CI 1.08–11.7, p = 0.036) and hypertension (aOR 3.34, 95% CI 1.01–11.1, p = 0.049). Cox regression confirmed femoral site (aHR 3.10, 95% CI 1.29–7.44, p = 0.011), hypertension (aHR 4.45, 95% CI 1.40–14.15, p = 0.011), and age ≥ 60 years (aHR 3.96, 95% CI 1.48–10.64, p = 0.006) as predictors of reduced patency. Conclusions: Femoral insertion site and hypertension were strong independent predictors of TCC dysfunction and shortened patency. Age ≥ 60 years additionally predicted reduced patency. These simple bedside factors support practical risk stratification in low-resource haemodialysis settings.
Sihombing et al. (Wed,) studied this question.