Taurolock versus saline 5% on preventing infection and dysfunction of hemodialysis catheters; a randomized, double blind controlled clinical trial

Abstract

Introduction: Despite the higher rate of morbidity and mortality, the use of central venous catheters has increased significantly compared to arteriovenous fistula. So far, no ideal organic solution has been identified for the prevention of thrombosis and catheter-related infection in patients undergoing hemodialysis. Objectives: This study aimed to evaluate the efficacy of Taurolock versus saline 5% on the prevention of catheter dysfunction and catheter-related infections. Patients and Methods: Seventy patients with chronic kidney disease, who requiring hemodialysis or those with permanent hemodialysis catheters referring to hemodialysis centers of Ahvaz, were selected and randomly divided into two groups, while 68 patients remained until the end of the study. In the first group, saline 5% was inserted into the lumen of catheter after each hemodialysis, and then catheter was blocked. In the second group, Taurolock solution (TauroLock™ -Hep 500®: Taurolidine; antimicrobial agent), citrate 4% and heparin (UI/mL) were used as antibiotics. Results: No significant difference between the catheter-related infection and positive blood culture in both saline and Taurolock groups was detected (2.94% versus 2.94%; P >0.05). Moreover, the catheter-related dysfunction in the saline 5% group was 5% less than the Taurolock group (2.94% versus 11.76%, P = 0.365). Conclusion: The results showed that saline 5% is at least as effective as a Taurolock solution for prevention of infections and catheter dysfunction. Saline is an effective, inexpensive, safe and readily available in various settings. Therefore, it could be considered as a proper alternative solution for reduction of dialysis-related side effects and costs. Trial Registration: Registration of trial protocol has been approved in Iranian registry of controlled trials (identifier: IRCT20190304042918N1; https://en.irct.ir/trial/38055, ethical code# IR.AJUMS.REC.1397.412).