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Abstract: SA-PO1028

Effect of Taurolidine Citrate and Unfractionated Heparin Combination on Inflammatory Response and Dialysis Adequacy in Hemodialysis Patients

Session Information

Category: Dialysis

  • 701 Dialysis: Hemodialysis and Frequent Dialysis

Authors

  • El-Sharkawy, Magdy M., Ain Shams university, Cairo, Egypt
  • Ezzat, Haitham, Ain Shams university, Cairo, Egypt
  • Rezk, Khaled Mohamed, Ain Shams university, Cairo, Egypt
  • Emara, Ahmed, Ain Shams university, Cairo, Egypt
  • Elsharabasy, Reem Mohsen, Ain Shams university, Cairo, Egypt
  • Mansour, Amr Mohamed, Ain Shams university, Cairo, Egypt
Background

In hemodialysis (HD) patients, Catheter-related infections and dysfunction are a major health problem. In Egypt, recent data show that 6.6% of HD patients use catheters, of which short term catheters represent 59.6% and 40.4% with long-term catheters. In this study, we aim to assess the effect of using Taurolidine citrate and unfractionated heparin combination, as a lock solution for temporary dialysis catheters, on inflammatory markers, incidence of catheter related infections (CRIs) and dialysis adequacy in HD patients.

Methods

A randomized controlled clinical trial included 60 stable HD patients from Ain-Shams University hospitals at the time of catheter insertion. Patients were randomized into 2 groups: Group 1: 30 Patients received taurolidine citrate (4%) and 500 i.u of heparin as a catheter lock after HD session. Group 2: 30 Patients received unfractionated heparin (heparin sodium 5000i.u/ml) as a catheter lock after HD session. Both groups were followed up for 1 month period and monitored for signs of CRbsI. Also, Urea reduction ratio (URR) were measured weekly. Highly sensitive CRP & Interleukin 6 (IL-6) were measured at baseline and 1 month after using the lock solutions. Blood cultures were withdrawn in patients who developed signs of CRIs.

Results

Group 1 (mean age 39.5 ± 14, 46.7% males), Group 2 (mean age 39.3 ± 14, 60% males). As regard inflammatory markers, a significant difference was noted between the 2 groups one month after catheter insertion (P: 0.001 and 0.018 for hsCRP and IL6 respectively), with the higher levels of inflammatory markers showed in group 2. Catheter performance determined by URR and blood flow rate between the 2 groups by the 4th weeks was significantly different in favor of group1, suggesting better performance of the catheter (P :0.007 and 0.001 respectively). CRIs were demonstrated in 9 patients group 2 (30%) in contrast to 1 patient only in group 1(3.3%) (P 0.006).

Conclusion

We may conclude that using Taurolidine citrate and unfractionated heparin combination as a lock solution for temporary dialysis catheters was associated with lower levels of inflammatory markers and lower incidence of CRIs when compared to the standard unfractionated heparin lock. Its use also was associated with better catheter performance.