대한신장학회

논문분류
제목	Tunneled Cuffed Hemodialysis Catheter: A Comparison of Outcomes between by Interventional Radiologist and by Interventional Nephrologist
저자	Yoo Hyung Kim, Ki Dae Kim, Ye Jin Kim, Sarah Chung, Dae Eun Choi, Ki Ryang Na, Kang Wook Lee
출판정보	2014; 2014(1):
키워드	혈액투석, 중재학적 신장내과, 중심정맥카테터
초록	Background: Historically, surgeons and interventional radiologist have performed the majority of all vascular access related procedure including placement of nontunneled hemodialysis catheter (NDC) and tunneled hemodialysis catheter (TDC), venography for arteriovenous fistula operation and percutaneous thrombectomy and angioplasty of arteriovenous fistula and graft. However, since 1995, interventional nephrology have established in America and recently, emerging in South Korea. We analyzed the outcomes of tunneled hemodialysis catheter between by radiologist and nephrologist. Method: Interventional nephrologist started procedure which was related to vascular access for hemodialysis since March 2012. We collected data by radiologist from since January 1 2011 through December 31 2011 and by nephrologist from since July 1 2012 through June 30 2013. We compared minute duration from hemodialysis decision to both placement of TDC (D-I duration) and initiation of hemodialysis (D-H duration), rate of catheter success, complication and temporary catheter use. Result: All 483 placed TDC cases were evaluated. 279 TDC was placed by interventional radiologist, and 204 were placed by interventional nephrologist for 2 separate years. D-I duration by nephrologist and radiologist were 571 minutes and 1032 minutes, respectively. D-H duration were 675 minutes and 1117 minutes, respectively. D-I duration and D-H duration between two groups whether using NDC before placement of TDC or not were also statistically significant. Frequency of using NDC and duration of using NDC did not show statistically significant differences. Rate of delayed oozing from catheter insertion site were 16.2% by radiologist and 10.9% by nephrologist (p=0.099). Other complications including pneumothorax, hemothorax and other cardiothoracic complications did not show statistically significant differences. Conclusion: Trained interventional nephrologist can perform TDC placement safely and effectively which minimized delays from hemodialysis decision to initiation. It would improve patient’s convenience and lower hospital costs.
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