A Review of Evolving Dialysis Catheter Technologies

Abstract

Dialysis catheters continue to play a vital role in the delivery of hemodialysis to patients for both temporary vascular access, serving as a bridge to permanent access, and for long-term access for patients with end-stage renal disease (ESRD). During the past decade, there has been an emergence of technological advancements in the design of dialysis catheters in an attempt to reduce catheter malfunction, decrease infection rates, and improve their long-term efficiency. New improvements in catheter design are aimed at translating into improved catheter performance. This review article summarizes some of the novel catheter designs developed within the last decade.

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

“…This design is thought to prevent clot formation ( Figure 1A). 10,17 In contrast, the relatively older step-tip catheter is composed of a soft, silicone material and is designed with a staggered tip to provide a 2.5 cm separation between the arterial lumen and venous tip ( Figure 1B). …”

“…8,9 Given the global trend towards an increasingly elderly hemodialysis population with a similar increasing prevalence of diabetes and cardiovascular comorbidities, the number of patients requiring chronic hemodialysis that are unsuitable for an AV fistula is increasing. 10,11 This is especially true in China, where the above factors are leading to an increasing incidence of end-stage renal disease (ESRD). 12,13 Continuous advances in catheter design have improved the durability of catheter function and also lowered the incidence of catheter-related infection.…”

“…12,13 Continuous advances in catheter design have improved the durability of catheter function and also lowered the incidence of catheter-related infection. 1,10 The symmetrical-tip dialysis catheter (Tal PalindromeÔ, Covidien, Mansfield, MA) is a recent catheter design with a symmetric, spiral tip, and biased ports. 14 Results from previous studies suggest that the symmetrical-tip catheter has several functional advantages over other catheter designs; for example, lower rates of thrombosis and re-intervention compared with split distal tip catheters, 15 and a lower dysfunction rate compared with steptip catheters.…”

Hemodialysis Access Infections, Epidemiology, Pathogenesis and Prevention

“…After this time, the catheter is more vulnerable to internal sources of infection, possibly via the catheter hub, leading to subsequent haematogenous spread and bloodstream infection. Alternatively, infection at a distant internal site may lead to colonisation of the indwelling catheter (Knuttinen et al, 2009).…”

Success rate of first haemodialysis post tunnelled dialysis catheter insertion

“…The arteriovenous fistula (AVF) is still the preferred vascular access for haemodialysis especially in the era of the Fistula First Initiative [2]. However due to a number of factors, including the presence of co-morbidities like diabetes and peripheral vascular disease, lack of vascular access due to late nephrological referral [3], and more patients of advanced age on HD some patients still start dialysis with a tunnelled dialysis catheter (TDC). Also, patients may need a catheter if there are native access related complications.…”