#5111 HEMODIALYSIS TUNNELED CATHETERS LOCK WITH TAUROLOCK™ VERSUS A COMBINATION OF GENTAMYCINE AND HEPARINE

Abstract

Abstract Background and Aims Catheter-associated infections (CAIs) and thrombosis (CAT) are the most common complications, associated with the use of tunneled catheters for hemodialysis. The incidence of infections is about 1.8-6.5/1000 catheter-days, and thromboses are the main cause of catheter dysfunction and loss of vascular access in 30-40% of patients. The aim of our study was to determine the incidence of these complications in patients in whom we used prophylactic “locking” of their tunneled catheters. Method The patients included in the study signed an Informed Consent (№29.06.2021) approved by the Research Ethics Committee at MU-Pleven. The study was conducted in the period 01.10.2021 - 31.03.2022, a total of six months. The study included 23 men and 22 women with an average age of 60.82 (+/-13,629) years, and the age difference between the three groups can be considered insignificant (P = .046). All patients had tunneled catheters placed >3 months ago (mean duration was 714 +/- 247 catheter-days) as the only vascular access for hemodialysis treatment. After a clinical examination and a negative result of two blood cultures, the patients were randomly divided into three groups of 15 (fifteen) people each, a total of 45 (forty-five) participants: group A – locking the catheter only with TauroLock™ (Tauropharm, Waldbüttelbrunn, Germany), group B – locking with gentamicin (10 mg/ml) and heparin (1250 IU/ml) and group C – locking with TauroLock™ for three months, then – with heparin and gentamicin for the next three months of the study. Patients were monitored for the major complications of catheter-related infection (CRI) and catheter-related thrombosis (CRT). All data was statistically processed with Statgraphics 19. Results The median duration for tunneled catheters was 8,105 catheter-days (CD). One complication was reported in each of the three groups: group A – one case of CRI, groups B and C – one case of CRT each. No cases of catheter-associated bloodstream infection, requiring prolonged treatment and catheter thrombosis, requiring replacement of the tunneled catheter were reported. Reported costs for patients treated with TauroLock™ were calculated at 3 EUR/each dialysis session, and for patients treated with gentamicin and heparin – 0.88 EUR/dialysis session. Conclusion The data from our study unequivocally support the thesis that locking the catheter with a solution containing TauroLock™ is comparable to the effect of locking the catheter with a solution containing an antibiotic and anticoagulant. In the short term, the difference in the price of medicines is significant, but it does not exceed the potential losses of public funds in the medium and long term. We recommend the use of a similar prophylactic regimen in all patients with tunneled catheters as the only possible vascular access for hemodialysis or with an expected duration of use greater than ninety days.