Concentrated sodium chloride catheter lock solution – a new effective alternative method for hemodialysis patients with high bleeding risk

Abstract

Background: Locking catheter with heparin may increase bleeding risk of some hemodialysis (HD) patients. Hence, the security and effectivity of 10% concentrated sodium chloride (CSC) used as an alternative method for patients with high bleeding risk need to be investigated. Methods: Seventy-two patients inserted temporary central venous catheters were divided into two groups randomly. A total of 3125 U/mL heparin saline (HS) was used in HS group and 10% CSC in CSC group to lock catheters. Heparin-free HD was used for the first time and plasma specimens were collected to test coagulation indicators before catheter-locking (at the end of HD) and at 30 min after it. Then, blood flow velocities (BFVs), incidences of catheter thrombosis, etc. were followed up at each time of HD. Results: Activated partial thromboplastin time (APTT) of two groups had no difference at the end of heparin-free HD (27.100 [25.675–28.950] vs. 27.250 [25.150–29.575] second, p = 0.933), but at 30 minutes after using different catheter lock solutions, APTT of HS group was obviously longer than CSC group (50.100 [41.275–65.400] vs. 27.500 [25.525–29.875] second, p < 0.001). Catheters’ retaining time of two groups were the same (p = 0.306), so did the average BFVs (p > 0.05). But catheters’ thrombosis incidence and urokinase usage of HS group were less than CSC group (p < 0.05). Conclusion: Comparing with HS group, thrombosis incidences of CSC group increased, but catheters’ retaining time and average BFVs remained the same and coagulation indicators of it were unaffected. Therefore, it can be an effective alternative lock method for HD patients with high bleeding risk.