Abstract
BackgroundData on renal replacement therapy (RRT) in cancer patients with acute kidney injury (AKI) in the intensive care unit (ICU) and how these factors influence the efficiency of dialysis and the outcomes of these patients are scarce. We aim to describe the predictive clinical characteristics of hemodialysis catheter-related complications in critically ill cancer patients with acute kidney injury.MethodsThis is a retrospective cohort study of 62 cancer patients subjected to short-term hemodialysis catheter implants. We evaluated the clinical characteristics of patients and the complications related to catheter implantation: mild malfunction, characterized by reversal of access lines; infections; and catheter replacement due to severe malfunction or infections. The outcomes analyzed were recovery of renal function, discharge from the ICU, and death.ResultsThe most frequent complications were related to mild malfunction, which justified dialysis line reversal in 21.3% of the patients. The complication rate was higher in patients undergoing conventional hemodialysis, in those with coronary disease, and in those who had more than three dialysis sessions. The presence of metastasis was more frequently related to catheter reversals. Patients with mild or severe malfunction were more likely to be hospitalized for more than 18 days in the ICU. All patients with mild malfunction had hospitalization times greater than 28 days.ConclusionsHemodialysis catheter-related complications were associated with longer ICU and hospital stays in cancer patients with AKI. Mild malfunction of the hemodialysis catheter was the most frequent complication. Patients with metastasis and sepsis, who used diuretics, and who used intermittent dialysis methods had milder catheter malfunctions.
Highlights
Data on renal replacement therapy (RRT) in cancer patients with acute kidney injury (AKI) in the intensive care unit (ICU) and how these factors influence the efficiency of dialysis and the outcomes of these patients are scarce
Data on renal replacement therapy (RRT) in cancer patients with acute kidney injury (AKI) in the intensive care unit (ICU) are scarce, and intermittent hemodialysis complications such as hypotension and clotting are common in some studies
Most catheters inserted into central veins develop fibrin clots one to several weeks after implantation and are silent at first, until they obstruct the distal part of the catheter; this clot development can be minimized by the conventional use of a heparin lock to prevent access thrombosis between hemodialysis sessions [6]
Summary
Data on renal replacement therapy (RRT) in cancer patients with acute kidney injury (AKI) in the intensive care unit (ICU) and how these factors influence the efficiency of dialysis and the outcomes of these patients are scarce. Data on renal replacement therapy (RRT) in cancer patients with acute kidney injury (AKI) in the intensive care unit (ICU) are scarce, and intermittent hemodialysis complications such as hypotension and clotting are common in some studies. The reversal of dialysis blood lines is a procedure used when the blood flow during hemodialysis is low or when venous or arterial bloodline pressures are high It is not a direct complication, dialysis blood line reversal represents a mild malfunction of the catheter that does not interrupt the procedure. Most catheters inserted into central veins develop fibrin clots one to several weeks after implantation and are silent at first, until they obstruct the distal part of the catheter; this clot development can be minimized by the conventional use of a heparin lock to prevent access thrombosis between hemodialysis sessions [6]
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