Evidence map›Paper›PMID 42587038›Full record

ArticlePediatric nephrology (Berlin, Germany)2026

Clinical performance and microstructural assessment of hemodialysis catheters for children on maintenance dialysis.

Claudia Bruno, Talia Greenbaum, Sanya Chopra, Ana Cecilia Navarro Ramirez, Ethan Wong, Rayan Moumneh, Lynsey Stronach, Kathryn Waters, Kate Walker, Premal A Patel and 9 more

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In one paragraph

Article in Pediatric nephrology (Berlin, Germany), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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0citing papers in PubMed
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1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

19 authors.

Claudia BrunoGreat Ormond Street Institute of Child Health, University College London, London, UK. c.bruno@ucl.ac.uk.ORCID http://orcid.org/0000-0001-9070-1297
Talia GreenbaumInstitute of Cardiovascular Science, University College London, London, UK.
Sanya ChopraGreat Ormond Street Institute of Child Health, University College London, London, UK.
Ana Cecilia Navarro RamirezGreat Ormond Street Institute of Child Health, University College London, London, UK.
Ethan WongGreat Ormond Street Institute of Child Health, University College London, London, UK.
Rayan MoumnehInstitute of Cardiovascular Science, University College London, London, UK.
Lynsey StronachGreat Ormond Street Institute of Child Health, University College London, London, UK.
Kathryn WatersGreat Ormond Street Institute of Child Health, University College London, London, UK.
Kate WalkerGreat Ormond Street Institute of Child Health, University College London, London, UK.
Premal A PatelGreat Ormond Street Institute of Child Health, University College London, London, UK.
Olumide OgunbiyiDepartment of Histopathology, Great Ormond Street Hospital for Children, London, UK.
Ciaran HutchinsonDepartment of Histopathology, Great Ormond Street Hospital for Children, London, UK.
Owen J ArthursGreat Ormond Street Institute of Child Health, University College London, London, UK.
Ian C SimcockGreat Ormond Street Institute of Child Health, University College London, London, UK.
Alexander D LalayiannisDepartment of Nephrology, Birmingham Children's Hospital, Birmingham, UK.
Amrit KaurDepartment of Paediatric Nephrology, Royal Manchester Children's Hospital, Manchester, UK.
Silvia SchievanoInstitute of Cardiovascular Science, University College London, London, UK.
Claudio CapelliInstitute of Cardiovascular Science, University College London, London, UK.
Rukshana ShroffGreat Ormond Street Institute of Child Health, University College London, London, UK.

Funding

Kidney Research UK ST_013_20220706National Institute for Health and Care Research NIHR303049
6 · The paper itself

Abstract

backgroundCentral venous catheters (CVCs) are the most common vascular access for pediatric hemodialysis (HD), despite frequent complications. We assessed outcomes of commonly used CVCs in children on maintenance dialysis comparing clinical outcomes with micro-CT and histology of the CVC after removal.

methodsData from children aged 0-18 years receiving maintenance HD were collected from three pediatric dialysis centers. CVC-related outcomes were analyzed to determine complication rates and access survival. CVC dysfunction and reasons for CVC removal were recorded. A consecutive subset of explanted CVCs was examined using high-resolution imaging (micro-CT) and histological sectioning to investigate the site, extent and nature of any occlusions.

resultsData were collected for 288 catheters (six sizes and six models) spanning 85,393 catheter-days. CVC dysfunction was recorded in 54.2% of the lines, most commonly due to infection (40.6%) and line occlusion (24.5%). The median CVC survival was 215.5 days, with 133 CVC replacements in 72 children. Infection rates ranged from 0.20 to 1.82 per 1000 catheter-days, depending on CVC size. Larger CVCs (≥ 14Fr) did not show better access survival compared to 10-Fr models, although this may be influenced by design differences. Micro-CT of 16 explanted CVCs revealed occlusions in all of them, with histological confirmation of thrombi in 7. Thrombi were rich in fibrin, implying an organized clot, and predominantly located in the region of the side holes and at the catheter tip.

conclusionsPediatric CVCs are associated with a high rate of dysfunction, leading to replacement in 44% of patients. Interestingly, diameters ≥ 10Fr (12.5Fr, ≥ 14Fr) were not associated with improved survival, whereas 8Fr catheters showed a non-significant trend toward increased occlusion and poorer catheter survival, suggesting a possible threshold effect. Micro-CT and histology confirmed the presence, site and extent of thrombi. These data can inform development and modeling of new CVC designs.

Indexed as

BioengineeringCentral venous cathetersHemodialysis

Identifiers

PMID42587038

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.