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Vascular Access in Children on Chronic Hemodialysis: A Slovenian Experience
Author(s) -
Rus Rina R,
Novljan Gregor,
ButurovićPonikvar Jadranka,
Kovač Janko,
Premru Vladimir,
Ponikvar Rafael
Publication year - 2011
Publication title -
therapeutic apheresis and dialysis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.415
H-Index - 53
eISSN - 1744-9987
pISSN - 1744-9979
DOI - 10.1111/j.1744-9987.2011.00954.x
Subject(s) - medicine , hemodialysis , arteriovenous fistula , dialysis , catheter , surgery , end stage renal disease , jugular vein , lumen (anatomy) , vascular access , incidence (geometry) , internal jugular vein , central venous catheter , retrospective cohort study , physics , optics
ABSTRACT The aim of our study was to report our experience with arteriovenous fistulas (AVFs) and non‐cuffed central venous catheters (CVCs) in children and adolescents with end‐stage renal disease (ESRD) on hemodialysis (HD). The children with ESRD (18 years or younger) who were hemodialyzed at the Center of Dialysis and Transplantation, Children's Hospital, Ljubljana, in the period between December 1998 and December 2010 were included in our retrospective study. We recorded the data considering the CVCs and AVFs used for HD. Thirty‐one children (13 females, 18 males) with ESRD received HD treatment. The mean patient age when HD was started was 13.3 ± 3.4 years. Altogether, 35 AVFs were created, and the primary failure rate was 25.7% (9/35). The time to maturation was 4.0 ± 2.5 months. The mean patency of the AVF was 42.5 ± 51.9 months. Seventy‐seven CVCs (non‐cuffed) were inserted in the observation period; 89.6% of the CVCs were inserted in the jugular vein, and citrate locking was used in the interdialysis period. The CVCs were removed after 0.1–17.4 months (3.6 ± 3.7 months). The incidence of bacteremia was 0.9 episodes per 1000 catheter days. The preferred vascular accesses for pediatric hemodialysis are native AVFs; however, a single lumen, non‐cuffed, citrate‐locked CVC placed in a jugular vein can be acceptable as a long‐term vascular access when AVF cannot be constructed or used.