الفهرس 
Introduction & aim of the workOnly 14 pages are availabe for public view
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Abstract
This current study was carried out at the Nephrology unit, Nephrology and Urology, Minia University Hospital, along the period from Sept 2021 to Sept 2022.
The aim of the study was to detection of complications of tunneled dialysis catheter and improving the outcome in those patients.
Our study included 86 patients who underwent TDC placement for hemodialysis, follow up of all participants for long term outcome of TDCs and the importance of catheter lock for the incidence of complications and outcome of TDCs, complications have also been categorized as early or late, cases were divided into 2 groups corresponding to catheter lock solution, group I: using heparin lock, group II: using taurolidine lock.
It has been observed five patients faced early complications including failed puncture, hematoma. and wrong canulation while others faced late complications, the most common was infection and catheter dysfunction.
In our study we reported catheter dysfunction in 12 (14 %) patients, 23.9% were in Heparin group and 2.5% in taurolidine group (p value= 0.004). eight patients (9%) suffered complications that resulted in catheter failure and subsequent removal.
Infection, and CRBSI in particular, is the most fear late complication correlated with TDCs due to its substantial mortality & morbidity. In our study, CRBSI was significantly higher in group I (10) cases (21.7%) than in group II who use taurolidine lock solution (p value= 0.031), causing hospitalization and catheter removal in 5 patients 10.9% (p value= 0.032).
We found that Gram positive organisms are responsible for most CRBSI episodes associated with TDCs (8.1%) and mostly due to staphylococcus aureus (5.8%), However, Candidemia was found in a 3 of our patients (3.5%). 2 of them receive antifungal treatment and improved but the other case complicated with infective endocarditis, hospitalized, received antifungal treatment and require catheter removal.
The findings of this study indicate that a significant proportion of the catheters (60.5%) were removed voluntarily by patients who had achieved permanent access through fistula formation or no longer required dialysis. The remaining catheters were removed for various reasons, including complications such as infection, blockage, physical damage, or in five cases, slipping.
The survival time of TDCs was significantly high. We found significant longer duration of TDC survival in taurolidine group (2-24 m) than in group I (p value ≤0.001) regardless of age, sex, and the distribution of primary diseases in the studied patients.