A reliable and well-functioning vascular access is pivotal for effective hemodialysis, ensuring an optimal quality of life for individuals with end-stage chronic kidney disease. Patients undergoing chronic dialysis treatment have three permanent vascular access options: arteriovenous fistula (AVF), arteriovenous graft (AVG), and tunneled central venous catheter (CVC). In recent years, the prevalence of patients utilizing permanent vascular catheters for HD treatment has been rising, necessitating a focus on reducing complications and prolonging their functional duration.
Common complications associated with central catheters encompass intra- or pericatheter thrombosis and catheter-associated infection (CAI). Varied CVC locking solutions are used to prevent infection and thrombosis. Regardless of the chosen locking solution type, utilizing thrombolytic agents for prophylaxis from catheter insertion onward is recommended to reduce the risk of thrombotic complications.
Taurolidine- and citrate-based locking solutions have demonstrated greater effectiveness compared to heparin-based locking solutions in addressing CVC-related infections, and they show similar efficiency in averting catheter-related thrombosis. However, studies directly comparing the efficacy of taurolidine- and citrate-based solutions are limited. Definitive conclusions regarding the superiority of CVC occlusion medications are yet to be established. Authoritative, randomized clinical trials are necessary to validate these initial findings.
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