TUNNELED HEMODIALYSIS CATHETERS - USE OF A SILVER-COATED CATHETER FORPREVENTION OF INFECTION - A RANDOMIZED STUDY

PURPOSE: To determine whether silver-coated tunneled hemodialysis cath eters reduce infection and to determine the frequency of central venou s thrombosis and stenosis with percutaneous placement of right interna l jugular vein dialysis catheters by interventional radiologists. MATE RIALS AND METHODS: Ninety-one patients were randomly assigned to a tre atment (silver-coated catheter; n = 47) or control (identical catheter without silver coating; n = 44) arm. Baseline venography was performe d. Catheter tips were cultured and venography was repeated at catheter removal. RESULTS: Mean duration of catheter placement was 92 days. In fection occurred in 11 patients (five int he treatment group, six in t he control group). Tip cultures in 15 patients (eight treatment, seven control) were positive without clinical infection. Infection and colo nization rates were slightly but not significantly higher in the treat ment group than in the control group. Silver-coated catheters in two ( 4%) patients were removed due to reaction to the coating. Completion v enograms (n = 72) showed new minor abnormalities in four (6%) patients and major abnormalities (stenosis, thrombosis) in three (4%) patients . Permanent venous abnormalities occurred in two (3%) patients. CONCLU SION: Silver coating does not confer a benefit against clinical infect ion or colonization. Interventional radiologic placement of tunneled d ialysis catheters yields a low frequency of permanent central venous t hrombosis and stenosis.