{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,3,7]],"date-time":"2025-03-07T05:18:52Z","timestamp":1741324732489,"version":"3.38.0"},"reference-count":20,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2025,3,6]],"date-time":"2025-03-06T00:00:00Z","timestamp":1741219200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,3,6]],"date-time":"2025-03-06T00:00:00Z","timestamp":1741219200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Nephrol"],"abstract":"<jats:title>Abstract<\/jats:title>\n          <jats:sec>\n            <jats:title>Background<\/jats:title>\n            <jats:p>The tunnelled haemodialysis catheter (TDC) removal is a necessary skill for the nephrology trainee as this task is undertaken routinely in renal units. Little published data exists to establish current practice and there is no national guidance regarding TDC removal in United Kingdom (UK). Anecdotally, trainees suggest they do not have sufficient supervised training in TDC removal. We aimed to establish the differences in training and practice in TDC removal among nephrology trainees across UK.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Method<\/jats:title>\n            <jats:p>We created an online survey with twenty questions for trainee and non-training nephrology registrars working in UK. The survey was distributed via regional renal training programme directors, UK Kidney Association, \u201cRenal SpR Club\u201d and online professional social networks including social media and instant messaging services.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>We received 75 responses from all of 14 postgraduate training deaneries. 91% reported renal registrars remove TDCs in their units. 53% of the operators were taught by another registrar. Only 16% report awareness of written local trust guidance on TDC removal. 43% reported removing\u2009&gt;\u200910 TDCs a year. Cut-down method is preferred over traction method for TDC removal. 63% remove TDCs in designated procedure areas, 52% obtain written consent and 65% wear full sterile personal protective equipment (PPE). 16% report removing TDCs alone with no assistant and 12% do not stop aspirin, antiplatelets or anticoagulants beforehand. 30% of operators reported experiencing a \u201cstuck catheter\u201d at some point in their careers.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p>This survey highlights that TDC removal is a common procedure and predominantly performed by renal physicians in teaching hospitals. It is mostly undertaken by registrar level doctors often without formal training or written guidelines with varying techniques. 68% of participants want this procedure to be part of mandatory training in the renal post graduate training curriculum.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Trial registration<\/jats:title>\n            <jats:p>Not applicable.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1186\/s12882-025-04034-1","type":"journal-article","created":{"date-parts":[[2025,3,6]],"date-time":"2025-03-06T15:54:09Z","timestamp":1741276449000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Differences in training and practice in tunnelled haemodialysis catheter removal: a survey of nephrology trainees across United Kingdom"],"prefix":"10.1186","volume":"26","author":[{"given":"Ismet","family":"Boral","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shalabh","family":"Srivastava","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joanna","family":"McKinnell","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2025,3,6]]},"reference":[{"issue":"2","key":"4034_CR1","doi-asserted-by":"publisher","first-page":"170","DOI":"10.5301\/jva.5000620","volume":"18","author":"K Letachowicz","year":"2017","unstructured":"Letachowicz K, Go\u0142\u0119biowski T, Kusztal M, Penar J, Letachowicz W, Weyde W, et al. Over-catheter tract suture to prevent bleeding and air embolism after tunnelled catheter removal. J Vasc Access. 2017;18(2):170\u20132.","journal-title":"J Vasc Access"},{"issue":"9","key":"4034_CR2","doi-asserted-by":"publisher","first-page":"3027","DOI":"10.3390\/ijerph17093027","volume":"17","author":"T Porazko","year":"2020","unstructured":"Porazko T, Hobot J, Ziembik Z, Klinger M. Tunnelled haemodialysis catheter removal: an underappreciated problem, not always simple and safe. Int J Environ Res Public Health. 2020;17(9):3027.","journal-title":"Int J Environ Res Public Health"},{"issue":"3","key":"4034_CR3","doi-asserted-by":"publisher","first-page":"651","DOI":"10.1148\/radiology.219.3.r01jn05651","volume":"219","author":"MD Kohli","year":"2001","unstructured":"Kohli MD, Trerotola SO, Namyslowski J, Stecker MS, McLennan G, Patel NH, et al. Outcome of polyester cuff retention following traction removal of tunneled central venous catheters. 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Semin Dial. 2015;28(5):E48\u201352.","journal-title":"Semin Dial"},{"issue":"4","key":"4034_CR8","doi-asserted-by":"publisher","first-page":"340","DOI":"10.5301\/jva.5000571","volume":"17","author":"NR Dossabhoy","year":"2016","unstructured":"Dossabhoy NR, Sangha B, Tapolyai MB, F\u00fcl\u00f6p T. Outpatient removal of tunneled Dialysis catheters by nephrology fellows in training at a veterans affairs medical center. J Vasc Access. 2016;17(4):340\u20134.","journal-title":"J Vasc Access"},{"issue":"4","key":"4034_CR9","doi-asserted-by":"publisher","first-page":"289","DOI":"10.5301\/jva.5000392","volume":"16","author":"VS Vellanki","year":"2015","unstructured":"Vellanki VS, Watson D, Rajan DK, Bhola CB, Lok CE. The stuck catheter: A hazardous twist to the meaning of permanent catheters. 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Semin Dial. 2010;23(5):536\u20139.","journal-title":"Semin Dial"},{"issue":"1","key":"4034_CR16","doi-asserted-by":"publisher","first-page":"4","DOI":"10.2174\/1874303X01609010004","volume":"9","author":"MJ Kelly","year":"2016","unstructured":"Kelly MJ, Anwar S, Vachharajani T, Karasek M, Ahmed S. LEARNING FROM IMAGES fundamental mistake during tunneled Hemodialysis catheter (TDC) removal. Open Urol Nephrol J. 2016;9(1):4\u20135.","journal-title":"Open Urol Nephrol J"},{"key":"4034_CR17","unstructured":"UKKA. Vascular Access for Haemodialysis 2023 [Available from: https:\/\/ukkidney.org\/health-professionals\/guidelines\/guidelines-commentaries"},{"issue":"4","key":"4034_CR18","doi-asserted-by":"publisher","first-page":"S1","DOI":"10.1053\/j.ajkd.2019.12.001","volume":"75","author":"CE Lok","year":"2020","unstructured":"Lok CE, Huber TS, Lee T, Shenoy S, Yevzlin AS, Abreo K, et al. KDOQI clinical practice guideline for vascular access: 2019 update. 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There were no experiments performed on humans or with human tissue. Ethical approval is not required according to Health Research Authority under paragraph 2.3.14 of UK policy document GAfREC (governance arrangements for research ethics committees) last updated and published on 20 July 2021. All participants gave their informed consent by completing the electronic survey as explained in the introduction of the survey. The electronic system does not allow submission of partially completed surveys. In the introduction of the survey the study aim and the rationale were explained, and the participants were advised that they would be giving their consent to participate in this study by completing the survey. The responses are anonymous.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"124"}}