Previous PICC Placement May Be Associated With Catheter-Related Infections in Hemodialysis Patients
Catheter-related infections (CRIs) are a significant source of morbidity and mortality in hemodialysis patients. The identification of novel, modifiable risk factors for CRIs may lead to improved outcomes in this population. Peripherally inserted central catheters (PICCs) have been hypothesized to compromise vascular access due to vascular damage and venous thrombosis, whereas venous thrombosis has been linked to the development of CRIs. Here we examine the association between PICC placement and CRIs.
A retrospective review was performed of all chronic hemodialysis catheter placements and exchanges performed at a large university hospital from September 2003 to September 2008. History of PICC line use was determined by examining hospital radiologic records from December 1993 to September 2008. Catheter-related complications were assessed and correlated with PICC line history.
One hundred eighty-five patients with 713 chronic tunneled hemodialysis catheter placements were identified. Thirty-eight of those patients (20.5%) had a history of PICC placement; these patients were more likely to have CRIs (odds ratio = 2.46, 95% confidence interval = 1.71–3.53, p < .001) compared with patients without a history of PICC placement. There was no difference between the two groups in age or number of catheters placed.
Previous PICC placement may be associated with catheter-related infections in hemodialysis patients.
KeywordsPICC Hemodialysis Infection Catheter-related infection Dialysis Dialysis catheter Catheter
Conflict of interest
The authors declare that they have no conflict of interest.
- 15.Stillman RM, Soliman F, Garcia L, Sawyer PN (1997) Etiology of catheter-associated sepsis. Correlation with thrombogenicity. Arch Surg 112:1497–1499Google Scholar
- 17.Hoggard J, Saad T, Schon D et al (2008) Guidelines for venous access in patients with chronic kidney disease. A Position Statement from the American Society of Diagnostic and Interventional Nephrology, Clinical Practice Committee and the Association for Vascular Access. Semin Dial 21:186–191CrossRefPubMedGoogle Scholar
- 18.Guidelines NK (2006) Clinical practice guidelines and clinical practice recommendations. http://www.kidney.org/Professionals/kdoqi/guideline_upHD_PD_VA/index.htm