A retrospective study of palindrome symmetrical-tip catheters for chronic hemodialysis access in China

Figures & data

Figure 1. Close-up view of the (A) symmetrical catheter (Tal Palindrome™) tip showing the symmetrical spiral-tip design and laser-cut side slot (arrow), and (B) the step-tip catheter (Quinton™ Permcath™), showing the side holes (arrow) and staggered tip, which provides a 2.5 cm separation between the arterial lumen and venous tip.

Table 1. Demographics and background disease characteristics.

	Symmetrical-tip, N = 118	Step-tip, N = 166	p
Mean age (years ± SD)	67.4 ± 15.2	67.8 ± 13.1	>0.05
Males (%)	48	71	>0.05
Reason for hemodialysis (%) (n)
Diabetic nephropathy	52 (61)	19 (32)
Hypertension	18 (21)	15 (25)
Metabolic disorders (diabetic   nephropathy or hypertension)	69 (82)	34 (57)	<0.01
Chronic nephritis	17 (20)	40 (67)
Polycystic kidney disease	3 (3)	4 (6)
Obstructive nephropathy	3 (3)	2 (3)
Lupus nephropathy	<1 (1)	4 (6)
Rheumatoid arthritis	<1 (1)	1 (2)
Tumor	<1 (1)	4 (7)
Renal transplant failure	<1 (1)	1 (2)
Unknown	5 (6)	10 (16)

Table 2. Summary of routes of catheter placement.

(%) (n)	Symmetrical-tip	Step-tip	p
Right internal jugular vein	91 (107)	88 (146)	>0.05
Left internal jugular vein	2 (2)	6 (10)
Right external jugular vein	6 (7)	2 (4)
Right subclavian vein	2 (2)	3 (5)
Left subclavian vein	0 (0)	1 (1)
Total	118	166

Table 3. Mean catheter dwell time, rates of incidence of low blood flow and incidence of infection.

	Symmetrical-tip, N = 118	Step-tip, N = 166	p
Mean catheter dwell time (days ± SD) (range)	329.44 ± 38.13 (18–713)	273.11 ± 25.41 (13–724)	<0.05
Total catheter days	33,874	45,342
Low blood flow cases (n)	44	311
Low blood flow occurrence rate^a	1.13	6.86	<0.01
Infection cases (n)	11	35
Infection rate^a	0.28	0.78	<0.01
CRBSI cases (n)	5	20
CRBSI occurrence rate^a	0.15	0.44	<0.01
Catheter withdrawal (n)	10	26	<0.05
Reason for catheter withdrawal (%) (n)
Any adverse event	50 (5)	77 (20)	<0.05
Infection	20 (2)	19 (5)
Catheter dysfunction (including low blood flow and abnormal position dysfunction)	30 (3)	19 (5)
Death (catheter still functional)	30 (3)	8 (2)
Kidney transplantation (catheter still functional)	20 (2)	8 (2)
Catheter changed to symmetrical-tip	NA	38 (10)
Cuff exposure	0 (0)	8 (2)

Notes: CRBSI, catheter-related blood stream infection.

^aRates were calculated as a number of events per 1000 catheter days.