Successful use of Tesio catheters in pediatric patients receiving chronic hemodialysis

Semipermanent venous catheters remain the most commonly used access for chr onic hemodialysis (HD) in pediatric patients. The recent availability of Te sio catheters in 7 and 10 F has expanded available HD catheter options for children and adolescents. We report our experience with Tesio catheter surv ival, complications, and effect on dialysis adequacy in comparison to stand ard dual-lumen (DL) catheters in our pediatric HD patients. Demographic dat a were similar between the two groups. Overall actuarial survival was signi ficantly longer for Tesio versus DL catheters (46% versus 0% at 1 year; P = 0.003). A comparison of smaller catheters (7 F Tesio catheter, 8 or 10 F D L catheter) showed that smaller Tesio catheters had a significantly longer survival (median survival, 244 versus 13 catheter-days; P < 0.01). Tesio 10 F catheters also survived significantly longer than the larger 11.5 and 12 F DL catheters (P < 0.02). Catheter sepsis occurred less frequently with T esio catheters (one episode/20 catheter-months) than DL catheters (one epis ode/5 catheter-months) despite the longer duration of Tesio catheters. Adeq uate dialysis (single-pool Kt/V > 1.2) was delivered with the same frequenc y, but for a longer duration with Tesio catheters (76% +/- 32% over 100 mon thly measurements versus DL catheter, 57% +/- 45% over 54 monthly measureme nts). Our clinical practice was to replace cuffed catheters when adequate d ialysis could not be delivered. We conclude that Tesio catheters provide su perior performance compared with DL catheters in terms of catheter survival , Infection rates, and duration of adequate performance. (C) 2001 by the Na tional Kidney Foundation, Inc.