The use of haemodialysis plastic cannula in prevalent patients with kidney failure: A feasibility crossover randomised trial study.

Abstract

Haemodialysis plastic cannulae have been limited to incident arterio-venous fistulae cannulation or in those who require a more flexible in situ access device. The feasibility of plastic cannulae in prevalent patients on haemodialysis has not been reported. To determine the feasibility of plastic cannulae in prevalent haemodialysis patients. Prospective feasibility crossover randomised control trial. Adults diagnosed with chronic kidney disease G5 requiring haemodialysis three or more times per week via a native arteriovenous fistula previously cannulated for at least 6 weeks. Cannulation success rate, cannulation manipulation type, arterial and venous needle pressure. Patient needle-related anxiety as measured by the 4-item Patient Health Questionnaire and Meditation in Dialysis Questionnaire and nurse satisfaction. Eight patients completed 12 weeks plastic canulae and metal needles. Plastic cannulae were less likely to be successful in cannulation compared to metal needles (odds ratio = 0.15; 95% confidence interval [CI]: 0.05-0.48; p = 0.001). There was no effect of type of needle on the change in arterial needle pressure or change in venous needle pressure and no effect of plastic needle on repositioning (relative risk [RR] = 1.09; 95% CI: 0.385, 3.089; p = .871) or gauze pillow application (RR = 0.936; 95% CI: 0.467, 1.874; p = .851) than metal needles, relative to no manipulation. There were low rates of psychological distress or needle-related anxiety towards plastic or metal needles. Plastic cannulae are feasible in prevalent haemodialysis patients, however, metal needles are still preferred in a haemodialysis center that has historically used metal needles.