ArticleItalian journal of pediatrics2024
Vascular access challenges in hemodialysis children.
Article in Italian journal of pediatrics, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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Who cites it
5 citing papers in PubMed.
- Comments on: Safety and Feasibility of Endovascular Management of Pediatric Dialysis Access.Cardiovascular and interventional radiology · 2025Article
- Economic evaluation of automated peritoneal dialysis among pediatric patients with end state kidney diseases in Thailand.Scientific reports · 2025Article
- Knowledge, attitudes, and practices toward training of vascular access in chronic hemodialysis patients among nephrology fellows in Southwest China.Scientific reports · 2025Article
- Complications of tunneled central venous catheter placement: a narrative review of risks, prevention, and management strategies.Frontiers in radiology · 2025Review
- Catheter-related bloodstream infection rates: Comparing cuffed vs. uncuffed catheters in a nationwide series of small children on chronic hemodialysis.Clinical nephrology · 2025Article
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8 authors.
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Abstract
backgroundHemodialysis (HD) success is dependent mainly on vascular access (VA). The aim of this study is to share the experience of Pediatric Nephrology Unit (PNU), Cairo University Children's Hospital (CUCH), with VA-related obstacles in end stage kidney disease (ESKD) HD children.
methodsThis is a retrospective analysis of VA related data of 187 ESKD children received regular HD over 3 year duration (2019-2021). Kaplan-Meier curves were used to present arteriovenous fistula (AVF) and cuffed catheters survivals.
resultsUncuffed central venous catheter (CVC) was the primary VA for HD in up to 97.3% with 2.7% of patients had AVF performed and attained maturation before initiation of regular HD. Fifty-six (29.9%) patients have inserted 120 tunneled CVCs. AVFs & AV grafts (AVF) were performed in 79 (42.2%) and 6 (3.2%) patients respectively. There were 112 uncuffed CVCs implanted beneath the screen in Rt internal jugular vein (IJV) (44%) Lt IJV (17%), right internal mammary vein (2.7%) while Trans hepatic (TH) technique was used to place 39 uncuffed CVCs (34%) in the inferior vena cava (IVC). Catheter-related bacteremia (CRB) was the most frequent complication in uncuffed and cuffed CVCs (2.58 / 100 catheters day and 10.1 /1000 catheter days respectively). AVFs achieved a high success rate (83%) after 757.71 ± 512.3 functioning days.
conclusionNative AVF is the preferred VA for pediatric HD but its creation is limited by the small sized vessels where non-cuffed CVC could be a reasonable relatively long-term alternative. Challenging situations (occluded central veins) could benefit from TH technique of CVC insertion in IVC.
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