Retrospective analysis of adequacy of hemodialysis using the Cannon catheter (Arrow International)

Abstract

Currently there is no published data using the Cannon catheter. Our purpose was to confirm adequacy of hemodialysis using the Arrow Cannon catheter. This retrospective study used patients from one nephrology practice, utilizing two dialysis centers. All patients in a two year period meeting inclusion/exclusion criteria referred for tunneled catheter placement were included. All catheters were placed by interventional nephrologist using ultrasound for vein cannulation and fluoroscopy for placement confirmation. Pump speed (Qb), venous and arterial pressures, Kt/V, urea reduction ratio (URR), and dialysis prescriptions/adherence to the prescription were reviewed at baseline and monthly for six months. Catheter removal or six months were the study endpoints. Complications were evaluated from time of insertion throughout the study period. 38 patients were enrolled in the study. All patients were treated in the outpatient setting. Insertion outcome was successful in all 38 patients. The average dialysis prescription was approximately 400 ml/min, 3.7 hours, and 3 days a week. The mean average pump speed for all months evaluated exceeded the K/DOQI guideline of 300 ml/min. by 67.9–101.4 ml/min. The differences were significant with p < 0.01. The mean Kt/V and URR% data for each month evaluated exceeded the K/DOQI guideline values of 1.2 for Kt/V and 63% for URR% by between .34–.24 and 8%–10%, respectively; the differences were all at a significant level with p < 0.01. Mean arterial pressures for all months evaluated ranged from −218.6 to −238.1, and venous pressures averaged between 179.8 to 213.7. Only three patients experienced late complications (all of which were infections) and no patients required hospitalization post complication. Two were bacteremic; the other had tunnel infection without positive blood cultures. This is the first retrospective study to evaluate the adequacy of hemodialysis with the Cannon catheter. Our study showed that flow rates and adequacy of hemodialysis can be reached using the Cannon catheter, with minimal complications.