Korean Journal of Nephrology 1997;16(1):80-85.

소아 혈액투석 환자에서 PernCath 도관 사용에 관한 연구

신명동 , 하일수 , 박문수 , 정해일 , 박귀원 , 최용

Abstract

Hemodialysis is a major mode of renal replacement therapy in children as well as CAPD. PermCath, a dual lumen silicone atrial catheter with a dacron cuff, has been used as vascular access for hemodialysis. Between Aug. 1, 1994 and Mar. 31, 1996, 29 children had been received PermCath catheter implantation for hemodialysis in the Department of Pediatrics, Seoul National University Children's Hospital. Their medical records were analyzed retrospectively. The mean age and weight of the patients were 9.84.6years (6months 17years) and 25.7±11.0kg (6.2kg 40kg), respectively. For short- term use (<=60days), 14 catheters were implanted and mean life span of the catheter was 25.1±16.5 days. The catheter was removed due to thrombosis of acute onset (<2weeks) in 2 patients. In additional 12 patients, the catheter was removed within 60days because of patients' death (2), recovery of renal function (3), renal transplantation (3) or switch to arteriovenous fistula (1) or CAPD (3). In 16 long-term (>60days) users, mean life span of the catheter was 230.8± 158.6days (61 591days) and the actuarial catheter survival rate at 1 year was 44 %. The mean recirculation rate checked in 5 patients was 9.6±4.0%. The rate of thrombotic occlusion was 1.5/1,000 catheter days. Most of the clots except one could be lysed with local urokinase therapy. The rate of catheter associated fever was 0.6/1,000 catheter days. One catheter needed revision due to malposition and local bleeding developed during the procedure. PermCath catheterization was immediate, durable and relatively safe vascular access in childhood hemodialysis.