Tunnelled haemodialysis catheters in central Free State: epidemiology and complications
Background: End stage renal disease (ESRD) is a disease with profound impact on the patient, health system and economy. Tunnelled haemodialysis catheters (TDC) are amongst the most common dialysis methods. It has been established internationally that certain demographic descriptors and aetiologies carry an increased risk of complications. There is a dearth of epidemiological profiling of ESRD patients with TDC in South Africa. Objective: To establish the epidemiological profile of patients who received TDC and to establish the complication rate, with the goal of demonstrating associations between the epidemiological profiles and complications. Method: This was a retrospective study of all patients who received TDC in an Academic Hospital Interventional Radiological Suite over a period of 60 months between 01 March 2011 and 29 February 2016. Results: A total of 179 patients received 231 catheters. The majority of patients were male (58.7%) and 35.8% of the patients resided in Mangaung. The leading aetiologies of ESRD included hypertensive nephropathy (43.6%), primary glomerular disease (17.3%) and HIV associated nephropathy (6.1%). Procedural complications occurred in 7/224 (3.1%) insertions, whilst 37/185 (20.0%) developed catheter related infection and 54/185 (29.2%) developed dysfunctional catheters. There were no deaths due to catheter related complications. Conclusion: Our patients’ demographic profile, ESRD aetiology, complication rate for procedural complications and catheter related infections are roughly on par with international studies, however, the catheter dysfunction rate is higher than in the aforementioned studies. This possibly reflects the difficulty of accessing specialist care for our patients, the majority of whom reside outside the Mangaung district. Further studies with larger patient numbers are required to demonstrate statistically relevant associations.