Prevalence of symptomatic deep vein thrombosis (DVT) in patients with temporary double lumen dialysis femoral catheterization-Experience from Multan institute of kidney diseases Multan (MIKD).

Khurrum Bashir; Shumaila Anwar; Muhammad  Rashid Asghar; Nayyar Saleem

doi:10.53778/pjkd74234

Authors

Khurrum Bashir Multan Institute of Kidney Diseases, MIKD
Dr Shumaila Anwar Multan Institute of Kidney Diseases, MIKD, Multan, Pakistan
Dr Muhammad Rashid Asghar Multan Institute of Kidney Diseases, MIKD, Multan, Pakistan
Dr Nayyer Saleem Multan Institute of Kidney Diseases, MIKD

DOI:

https://doi.org/10.53778/pjkd74234

Keywords:

Deep vein thrombosis,, prevalence, double lumen dialysis catheter, femoral, hemodialysis, vascular access

Abstract

Objective: The study was conducted in Multan institute of kidney diseases to explore the DVT prevalence after double lumen dialysis femoral catheterization for haemodialysis.

Methodology: Retrospective cross sectional study was conducted in Multan Institute of Kidney Diseases, all double lumen dialysis femoral catheters passed over a period of five years (sep-2017 to sep-2022) were included in study, identified from electronic system of hospital. Except for those with temporary femoral catheters, all patients met the exclusion criteria. SPSS version 25 was used for data analysis and prevalence of DVT was calculated.

RESULTS: Total 6628 patients with a mean age of 48(range 14 -90 years) were catheterized, 4105(61.9%) males and 2523(38.1%) were females, right sided catheters were 1826(27.5%) and 4802(72.5%) patients underwent left sided insertions. Duplex ultrasound was done of all symptomatic 252(3.8%) patients and femoral DVT was confirmed in 174(2.6%) that is 69% of symptomatic patients. The incidence of DVT significantly (3.7 fold) increase at day six and onward. Prevalence of DVT is 2.6% in all catheterized and 69% of symptomatic patients.

Conclusion: Femoral vein remains an important emergency haemodialysis access route. Physicians inserting femoral venous catheters should be aware of the risk of lower extremity DVT from day three and consider performing duplex ultrasound examinations at day five and onwards if it is extremely necessary to be kept in situ for this duration, otherwise attention should be paid gaining access elsewhere at earliest possible opportunity.

References

Kidney International Supplements (2012) 2, 8–12(kdigo)

Liu M, Liu L, Huang F, Fang Y, Zhong G, Zhou X. Perioperative treatment of femoral neck fracture with deep venous thrombosis:A case report. Chin J Traumatol. 2015;18(2):109-12 DOI: 10.1016/j.cjtee.2014.09.003

White RH. The epidemiology of venous thromboembolism. Circulation 2003;107:I-4–I-8. DOI: 10.1161/01.CIR.0000078468.11849.66

van Korlaar IM, Vossen CY, Rosendaal FR, Bovill EG, Cushman M, Naud S, et al. The impact ofvenous thrombosis on quality of life. Thromb Res 2004;114:11–18. DOI: 10.1016/j.thromres.2004.04.007

Kahn SR, Ducruet T, Lamping DL, Arsenault L, Miron MJ, Roussin A, et al. Prospective evaluationof health-related quality of life in patients with deep venous thrombosis. Arch Intern Med 2005;165:1173–1178. DOI: 10.1001/archinte.165.10.1173

Li Q, Yu Z, Chen X, Wang J, Jiang G. Risk factors for deep venous thrombosis of lower limbs in postoperative neurosurgical patients. Pak J Med Sci. 2016;32(5):1107–1110. doi:10.12669/pjms.325.10481. [PMC free article] [PubMed] [Google Scholar]

The prevalence of deep Venous thrombosis of the lower extremity in hospitalised bedridden orthopaedic patients: a pilot studyJagdesh Kumar, Badaruddin Sahito, Muhammmad Soughat Katto, Nusrat Rasheed, Asif Ali Jatoi, Awais Abro. DOI:10.47391/JPMA.6991

Deep venous thrombosis caused by femoral venous catheters in critically ill adult patients.Joynt GM, Kew J, Gomersall CD, Leung VY,LiuEK.Chest.2000Jan;117(1):178-83. DOI: 10.1378/chest.117.1.178

White R, Zhou H, Romano P. Incidence of idiopathic deep venous thrombosis and secondary thromboembolism among ethnic groups in California. Ann Intern Med. 1998;128:737–740. DOI: 10.7326/0003-4819-128-9-199805010-00006

Stein PD, Kayali F, Olson RE, Milford CE. Pulmonary thromboembolism in Asians/Pacific Islanders in the United States: analysis of data from the National Hospital Discharge Survey and the United States Bureau of the Census. Am J Med 2004;116:435–442. DOI: 10.1016/j.amjmed.2003.11.020

Tsai AW, Cushman M, Rosamond WD, Heckbert SR, Polak JF, Folsom AR. Cardiovascular risk factorsand venous thromboembolism incidence: the Longitudinal Investigation of Thromboembolism Etiology. Arch Intern Med 2002;162:1182–1189. DOI: 10.1001/archinte.162.10.1182

Piovella F, Wang CJ, Lu H, Lee K, Lee LH, Lee WC, et al. Deep-vein thrombosis rates after major orthopedic surgery in Asia. An epidemiological study based on postoperative screening with centrally adjudicated bilateral venography. J Thromb Haemost 2005; 3: 2664-70. DOI: 10.1111/j.1538-7836.2005.01621.x

Leung V, Lui W, Chan T, Wong RS, Cheng G. Incidence of deep vein thrombosis in hospitalized Chinese medical patients is similar to that in western populations. Thromb Res 2006;118:763–764 DOI: 10.1016/j.thromres.2005.12.014

Cheuk BL, Cheung GC, Cheng SW. Epidemiology of venous thromboembolism in a Chinesepopulation. Br J Surg 2004;91:424–428. DOI: 10.1002/bjs.4454

Folsom AR, Cushman M, Tsai MY, Aleksic N, Heckbert SR, Boland LL, et al. A prospective studyof venous thromboembolism in relation to factor V Leiden and related factors. Blood 2002;99:2720–2725. DOI: 10.1182/blood.v99.8.2720

Folsom AR, Cushman M, Tsai MY, Heckbert SR, Aleksic N. Prospective study of the G20210Apolymorphism in the prothrombin gene, plasma prothrombin concentration, and incidence of venousthromboembolism. Am J Hematol 2002;71:285–290. DOI: 10.1002/ajh.10229

Jun ZJ, Ping T, Lei Y, Li L, Ming SY, Jing W. Prevalence of factor V Leiden and prothrombin G20210A mutations in Chinese patients with deep venous thrombosis and pulmonary embolism. Clin Lab Haematol 2006;28:111–116. DOI: 10.1111/j.1365-2257.2006.00757.x

Dilley A, Austin H, Hooper WC, Lally C, Ribeiro MJ, Wenger NK, et al. Relation of three genetictraits to venous thrombosis in an African-American population. Am J Epidemiol 1998;147:30–35. DOI: 10.1093/oxfordjournals.aje.a009363

Folsom AR. Update on factor V Leiden association with venous thromboembolism in the LITE Study. Blood 2007;109:1336–1337. DOI: 10.1182/blood-2006-10-052100

Dowling NF, Austin H, Dilley A, Whitsett C, Evatt BL, Hooper WC. The epidemiology of venousthromboembolism in Caucasians and African-Americans: the GATE Study. J Thromb Haemost. 2003;1:80–87. DOI: 10.1046/j.1538-7836.2003.00031.x

Lutsey PL, Cushman M, Steffen LM, Green D, Barr RG, Herrington D, et al. Plasma hemostaticfactors and endothelial markers in four racial/ethnic groups: the MESA study. J Thromb Haemost. 2006;4:2629–2635. DOI: 10.1111/j.1538-7836.2006.02237.x

Khan AA, Zafar SN. Venous thromboembolism in Pakistan: a neglected research agenda. J Thromb Thrombolysis 2013; 35: 234-42. DOI: 10.1007/s11239-012-0799-2

Leizorovicz A, Turpie AG, Cohen AT, Wong L, Yoo MC, Dans A; SMART Study Group. Epidemiology of venous thromboembolism in Asian patients undergoing major orthopedic surgery without thromboprophylaxis. The SMART study. J Thromb Haemost 2005; 3: 28-34. https://doi.org/10.1111/j.1538-7836.2004.01094.x