Deep venous thrombosis following placement of temporary hemodialysis catheter
Abstract:
Background: In India, 50% of patients with chronic kidney disease (CKD) present with end-stage renal disease (ESRD) and undergo hemodialysis (HD) primarily via an HD catheter (HDC). CKD is a risk factor for catheter-related thrombosis (CRT), which is well described in the literature, whereas deep venous thrombosis (DVT) is not. The real-world scenario in developing countries is that patients often use temporary HDCs, even for prevalent HD.
Materials and methods: We aimed to determine the incidence rates of DVT and its contributing factors. Patients with temporary non-tunneled HDCs placed for maintenance HD (on an emergency basis or until the maturation of arteriovenous fistula (AVF)) were followed-up for 3 months. Those already undergoing HD elsewhere were excluded. The incidence rates of DVT per 1,000 catheter days were calculated.
Results: The mean age was 46.6 ± 13.47 years; 190/278 were males. 140 patients had CKD for < 6 months. 103 patients had at least 1 risk factor. 24/278 (8.6%) developed DVT, giving an incidence rate of 0.95/1,000 catheter days. A median of 7 HD sessions and a mean of 19.8 ± 6.4 days before the development of DVT was seen. The odds ratios for developing DVT in the right internal jugular vein (IJV), left IJV, right femoral, and left femoral veins were 0.2, 5.0, 1.1, and 4.3, respectively. 31 developed catheter-related bloodstream infection (CRBSI); 6 had both coexisting DVT and CRBSI.
Conclusion: DVT incidence was low. CKD requires early diagnosis and HD planning. CRT is common; patient education and sonographic screening in patients with HDCs may enable a quicker diagnosis and therapy of DVT since many are asymptomatic.
Reference:
Palakkool S, Viswanathan S, Adithan S, Selvaraj J. Deep venous thrombosis following placement of temporary hemodialysis catheters in patients with end-stage renal disease. Clin Nephrol. 2025 Nov 25. doi: 10.5414/CN111196. Epub ahead of print. PMID: 41287925.