COST OF CENTRAL VENOUS CATHETERS AS VASCU LAR ACCESS IN CHRONIC-HEMODIALYSIS PATIENTS

The use of catheters as vascular access in chronic haemodialysis has b een increasing in recent years in nephrology units. This is due to the ageing of people entering chronic dialysis programs, rising proportio n of diabetic patients and, in our case, a real difficulty to have a v ascular surgeon available. Our aim was to measure the cost of maintain ing reviewed patients or chronic dialysis using catheters until the fi stula has been done. We reviewed the catheters placed in 1994 and esti mate the cost of the use of antibiotic and urokinasa, hospital days du e to catheter insertion and complications and one extra hour dialysis in case of single needle or low flow. We implanted 145 catheters in 57 patients, 58 +/- 16 years old and 20.6 +/- 39.8 months in dialysis. T here were 134 temporary catheters (TC), 131 single and 3 double lumen, and II permanent catheters (PCI. Most of TC were femoral with accepta ble duration. The mean cost of the catheter and expenses of its placem ent amounted to double lumen 11,424 +/- 798 ptas. for single lumen, 25 ,282 +/- 918 ptas. for Mahurcar and to 68,518 ptas. for PC. The expens es of one extra hour of haemodialysis in case of single needle or low flow in the PC totalled 134,498 +/- 118,567 ptas. for single lumen and 19,466 +/- 34,098 ptas. for PC (p < 0,01). The expenses of hospitaliz ation were similar. The total mean cost was 168,965 +/- 151,682 ptas. per single lumen catheter and 128,041 +/- 61,204 ptas. per PC (not sig nificantly different). However, when we corrected the price according to the duration of each catheter, the cost was 5,356 +/- 3,652 ptas. f or single lumen and nic dialysis patients using TC is an extra expense that should be kept in mind and encourage to obtain a vascular access as soon as possible.