Catheter-related complications among children treated with hemodialysis

Abstract ObjectivesCentral venous catheters (CVCs) used for hemodialysis access are associated with various complications and pose significant risks of morbidity and mortality. Complications can occur during insertion, dwell time, and catheter removal. This study was conducted to identify the risk factors and estimate the incidence of catheter-related complications in children undergoing hemodialysis.MethodsThis prospective cohort study was conducted between July 2021 and December 2022. Incidence rates per 1000 catheter days were calculated for complications, including catheter-related bloodstream infection (CRBSI), mechanical complications, and thrombosis.ResultsNinety-seven children were included in the study. The mean age was 103.48 ± 34.98 months. The right internal jugular vein was the most common insertion site (72.2%). Non-tunneled catheters were used in 93.8% of the cases and tunneled in 6.2% of the total cases. Of the total complications observed, 87.5% were seen in the non-tunneled catheters and 12.5% in the tunneled catheters. CRBSI was the most common complication (3.21 episodes/1000 catheter days), followed by mechanical catheter dysfunction (1.84/1000 catheter days) and thrombosis (1.38 episodes/1000 catheter days). The mean duration of the catheter in situ was 17.41 days, with a moderate positive correlation between the occurrence of complications and the catheter duration (rho = 0.34, p = 0.018). Risk factors for complications included a history of hemodialysis, low serum albumin levels, tunneled catheters, and right femoral site placement.ConclusionIn children undergoing hemodialysis, the most common complications were CRBSI, mechanical catheter dysfunction, and thrombosis. An extended duration of CVC use is associated with a higher likelihood of complications.