Establishing Long-Term Haemodialysis Vascular Access with Permcath in Children with Chronic Kidney Disease: A Single-Centre Retrospective Analysis

Abstract

Background: In some regions, the types and sizes of tunneled central venous catheters (CVCs) are limited. Objective: The objective of this study was to review our experience with 10F Quinton Permcath catheters used for long-term vascular access in children of various ages and weights with chronic renal failure. Methods: Children with renal failure on maintenance hemodialysis who underwent placement of the 10F Quinton Permcath between June 2017 and June 2023 at the First Affiliated Hospital of Jinan University were included. We collected clinical data from children with the Permcath, including patients' gender, age, weight, and height. Additionally, data on catheter-related complications were gathered. Imaging data of the patients were obtained to compare the catheter route on imaging and the position of the catheter tip in each case. This enabled an analysis of the characteristics of vascular access establishment and its correlation with catheter-related complications in 11 children implanted with 10F Quinton Permcath. Results: Among the 11 children on maintenance hemodialysis with catheters, five were male, and six were female, with a median age of 9 years (range 8 - 10). The median body weight of the included patients was 23.00 kg (range: 19.95 - 24.30 kg). Eight cases involved placement in the right internal jugular vein (IJV), with the catheter tip located at the level of T8 in two cases, T5 in one case, and T7 in the remaining cases, with no early catheter dysfunction. Three patients underwent catheter placement in the left IJV, with the catheter tip located at the level of T5, T4, and the T7/T8 intervertebral space, respectively, and two cases of early catheter dysfunction occurred in two patients. There were no acute complications in the 11 cases following catheter insertion. Conclusions: Whenever feasible, the right IJV should be the preferred choice for establishing vascular access for the 10F Quinton Permcath in children with chronic kidney disease, regardless of age and weight. The tunnel route and catheter length within the tunnel can be adjusted to ensure the appropriate placement of double-lumen tunnelled cuffed catheters (TCC).