Kidney Week

Abstract: SA-PO1101

Timing of Tunneled Dialysis Catheter Placement Among Hospitalized Patients Initiating Hemodialysis

Session Information

• Kidney Replacement Therapy and Care Delivery Innovations
  October 24, 2026 | Location: Exhibit Hall A, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Dialysis

• 801 Dialysis: Hemodialysis and Frequent Dialysis

Authors

• Manchanayake, Oshadhi, New York City Health and Hospitals South Brooklyn Health, New York, New York, United States

Oshadhi Manchanayake, MD

• Sultana, Syeda Salima, New York City Health and Hospitals South Brooklyn Health, New York, New York, United States

Syeda Salima Sultana, MD

• Islam, Nayeemul, Sir Salimullah Medical College, Dhaka, Dhaka Division, Bangladesh

Nayeemul Islam

• Winter, Rebecca P., New York City Health and Hospitals South Brooklyn Health, New York, New York, United States

Rebecca P. Winter, DO

• Keshetty, Sharan Siddharth, New York City Health and Hospitals South Brooklyn Health, New York, New York, United States

Sharan Siddharth Keshetty, MD, MBBS

• Bohush, Alena, New York City Health and Hospitals South Brooklyn Health, New York, New York, United States

Alena Bohush, MD

• Abrishami, Shabnam, New York City Health and Hospitals South Brooklyn Health, New York, New York, United States

Shabnam Abrishami, MD

• Rahman, Farzana, New York City Health and Hospitals South Brooklyn Health, New York, New York, United States

Farzana Rahman, MD, MBBS

• Lee, Winston, New York City Health and Hospitals South Brooklyn Health, New York, New York, United States

Winston Lee, MD

Background

Hospitalized patients with acute kidney injury requiring hemodialysis are often started on a non-tunneled central venous catheter (CVC). If ongoing dialysis is needed, transition to a tunneled CVC is required for long-term access. However, optimal timing remains unclear. This study evaluated whether tunneled CVC timing was associated with end-stage renal disease (ESRD) at discharge.

Methods

This retrospective quality improvement study included hospitalized patients at South Brooklyn Health who initiated hemodialysis through a non-tunneled CVC between 2017 and 2024. Patients with prior ESRD were excluded. The primary outcome was ESRD at discharge. The main predictor was time from non-tunneled CVC placement to tunneled CVC placement or catheter removal. Multivariable logistic regression adjusted for age, gender, diabetes, hypertension, CKD, baseline GFR, and CHF.

Results

Among 585 patients, 55.2% were discharged with ESRD. Each one-day delay in tunneled CVC placement increased the odds of ESRD by 6.4% (OR 1.064; 95% CI 1.044–1.084; p<0.001). ESRD rates increased with longer wait times: 44.6% with early placement <10 days, 61.2% with standard placement 10–14 days, and 71.3% with delayed placement >14 days. Hypertension was strongly associated with ESRD (OR 8.123; p<0.001), while higher baseline GFR was protective (OR 0.973; p<0.001).

Conclusion

This study demonstrates a significant time-dependent association between delayed tunneled CVC placement and increased ESRD at discharge. Patients receiving placement within 10 days had the lowest ESRD rate, suggesting that the current 10–14 day target may be suboptimal. Hypertension and lower baseline GFR were also significant predictors. These findings support earlier tunneled CVC placement, ideally within 10 days when clinically appropriate, to improve renal outcomes and discharge planning.

ESRD by Timing Group