Safety and efficacy of taurolidine/urokinase versus taurolidine/heparin as a tunneled catheter lock solution in hemodialysis patients: A prospective, randomized, controlled study

Fadwa Al-Ali, Ahmad F. Hamdy, Abdullah Hamad, Mohamed Elsayed, Zafar Zafar Iqbal, Aisha Elsayed, Rania Ibrahim, Hoda Tolba, Hisham Buanan, Ashraf Fawzy

Research output: Contribution to journalArticlepeer-review

Abstract

Background. Taurolidine citrate with heparin (Taurolock/Hep) is a promising central venous catheter lock solution. Despite its universal use among our hemodialysis patients, the prevalence of catheter malfunction was high. We aimed to compare Taurolock/Hep and taurolidine citrate with urokinase (Taurolock/U) as a catheter lock solution in order to identify whether either solution could reduce catheter-related dysfunction. Methods. In this prospective, randomized, controlled trial, patients were randomized to receive either Taurolock/Hep or Taurolock/U and were followed for 6 months. Episodes of acute catheter thrombosis, requirement of recombinant tissue plasminogen activator (rt-PA) and incidence of catheterrelated blood stream infection (CRBSI) were recorded, along with dialysis adequacy (Kt/V), blood flow rates (BFRs) and adverse events. Results. There were 93 inclusions (85 patients) in the Taurolock/Hep group and 84 inclusions in the Taurolock/U group (79 patients). Three catheters were removed in the Taurolock/Hep group because of acute thrombosis, while no catheter was removed for the same reason in the Taurolock/U group. The total number of all-causes catheter exchange (acute thrombosis and CRBSI) was significantly lower in Taurolock/U group (P=0.028). rt-PA was used significantly less often in the Taurolock/U group than in the Taurolock/Hep group (P=0.006). Moreover, higher BFR and Kt/V were noted in the Taurolock/U group than in the Taurolock/Hep group, although the differences were not uniformly significant. Conclusion. Taurolock/U is a safe and effective tunneled dialysis catheter lock solution, with a low rate of catheter exchange.

Original languageEnglish
Pages (from-to)619-626
Number of pages8
JournalNephrology Dialysis Transplantation
Volume33
Issue number4
DOIs
Publication statusPublished - 1 Apr 2018
Externally publishedYes

Keywords

  • catheter lock solution
  • catheter-related dysfunction
  • hemodialysis
  • taurolidine/heparin
  • taurolidine/urokinase

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