WHAT IS THE BEST DIALYSIS CATHETER LOCK SOLUTION – A SYSTEMATIC ANALYSIS OF PUBLISHED STUDIES
Maximilian Wurster1, Frieder Keller1
1Internal Medicine 1, Nephrology, University Hospital, Ulm, Germany
INTRODUCTION AND AIMS: About 20 % of all patients on hemodialysis need a catheter for vascular access. Clinical judgement about the advantages of the various lock solutions can be based on 3 criteria: (i) risk of catheter-related blood stream infec- tion (CRBSI), (ii) frequency of thrombosis with malfunction and (iii) cost. We made a systematic literature analysis on what the best lock solution might be.
METHODS: Out of 4106 studies published between 2006 and 2017, the 40 were selected reporting on a controlled trial with at least two lock solutions. The studies reporting on the following 4 lock solutions were compared: heparin, citrate (4 %), taur- olidin, alteplase/ urokinase – or various combinations of them. Studies on gentamicin, EDTA, citrate 30 % and parabene were not further considered due to outdated or inconclusive data. The sum of risk score ranking was used to simultaneously account for advantages and disadvantages of the solutions.