Hemodialysis Catheter Complications in the Emergency Department Versus Hemodialysis Unit

Overview

This prospective observational cohort study was designed to compare the risk of catheter thrombosis and catheter-related infection between adult patients who underwent temporary hemodialysis catheter insertion in the emergency department and those who underwent catheter insertion in the hemodialysis unit. The study was conducted at Antalya Training and Research Hospital. Adult patients aged 18 years and older who underwent hemodialysis catheter insertion in either the emergency department or the nephrology hemodialysis unit were included. A total of 398 patients were enrolled between December 1, 2024, and December 1, 2025. Demographic and clinical data were collected, and catheter-related complications occurring within 10 days after catheter insertion were assessed using hospital records and follow-up data.

Hemodialysis catheters are frequently used as temporary vascular access in patients requiring urgent or ongoing hemodialysis. Although these catheters provide rapid access for dialysis, catheter-related complications such as thrombosis and infection may result in catheter dysfunction, interruption of dialysis, repeated catheter placement, increased morbidity, and additional healthcare burden. In emergency departments, temporary hemodialysis catheters are often inserted under urgent clinical conditions. Although standard aseptic and antiseptic measures are applied, factors such as limited preparation time, clinical instability of the patient, and the need for rapid dialysis may affect the risk of catheter-related complications. In contrast, catheter insertion in a hemodialysis unit is generally performed in a more controlled clinical environment. This prospective observational cohort study compared two groups of adult patients: those who underwent temporary hemodialysis catheter insertion in the emergency department and those who underwent catheter insertion in the nephrology hemodialysis unit. The primary focus was to evaluate whether the catheter insertion setting was associated with differences in the development of catheter thrombosis and catheter-related infection within ten days after catheter placement. The study included 398 adult patients treated at Antalya Training and Research Hospital between December 1, 2024, and December 1, 2025. Demographic and clinical data were collected, and complications occurring within ten days after catheter insertion were assessed using hospital records and follow-up data. The findings of this study may help determine whether additional preventive measures are needed for hemodialysis catheter insertion procedures performed in emergency department settings.