Jais Kumar Karmani, Saima Mir, Syed Mohsin Naveed, Syed Asim Ali Shah, Muhammad Khalid Javaid, Fareena Asim, Armughan Ahmad.
Comparison of Catheter Related Blood Stream Infections in Hemodialysis patients Treated with Trisodium Citrate as Catheter Locking Solution vs Heparin as Conventional Locking Method.
Ann Pak Inst Med Sci Jan ;19(3):307-12.

Objective: To compare the frequency of temporary catheter related blood stream infections using sodium citrate as catheter locking solution with heparin as standard in hemodialysis patients. Methodology: A randomized controlled trial was conducted at a nephrology department's hemodialysis unit in Pakistan Institute of Medical Sciences (PIMS) between August 2022 and February 2023. Total 110 consecutive end-stage renal disease patients, aged above 18 years, undergoing hemodialysis with temporary central venous catheters, were divided into two groups. Group-I received trisodium citrate 46.7% as a lock solution, while Group-II received heparin 2000 U/ml (control). Results: The average age of patients in both groups was 51.98±13.57 years. The average duration of dialysis in both groups was 4.01±3.1 months and mean catheter time in Group-I was 13.65±8.29 days and in group-II was 13.40±8.33 days with statistically insignificant (p ? 0.05). The rate of CRBSI per 1000 catheter days was 3.12 days for group I and 5.14 days for group II (p = 0.001). The cumulative mean infection-free catheter survival in the trisodium citrate group was lower than the heparin group (log rank = 2.31, p = 0.128). Cox regression survival analysis between two groups; the difference in group I & II was insignificant (HR = 1.6, CI = 0.49–1.17, p = 0.201). Conclusion: There is insignificant difference between trisodium citrate 46.7% and heparin as a catheter lock solution in the survival rate of tunneled hemodialysis catheters in end-stage renal disease.

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