{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,9]],"date-time":"2026-07-09T03:41:20Z","timestamp":1783568480690,"version":"3.55.0"},"reference-count":14,"publisher":"SAGE Publications","issue":"1","license":[{"start":{"date-parts":[[2014,2,9]],"date-time":"2014-02-09T00:00:00Z","timestamp":1391904000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Vasc Access"],"published-print":{"date-parts":[[2015,1]]},"abstract":"<jats:sec><jats:title>Purpose<\/jats:title><jats:p> Tunneled dialysis catheters are the most common form of vascular access among incident dialysis patients in the United States. Fibrin sheath formation is a frequent cause of late catheter dysfunction requiring an exchange procedure with balloon disruption of the fibrin sheath. It is unknown whether fibrin sheath disruption is associated with increased incidence of bacteremia or catheter failure. <\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p> We reviewed all tunneled dialysis catheter exchange procedures at the University of Wisconsin between January 2008 and December 2011. The primary outcome was incidence of bacteremia, defined as positive blood cultures within 2 weeks of the procedure. Catheter failure, requiring intervention or replacement, was examined as a secondary outcome. Baseline characteristics examined included diabetic status, gender, race and age. <\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p> A total of 163 procedures were reviewed; 67 (41.1%) had fibrin sheath disruption and 96 did not. Bacteremia occurred in 4.5% (3\/67) of those with and 3.1% (3\/97) of those without fibrin sheath disruption (p=0.65). Fibrin sheath disruption was not significantly associated with the risk of catheter failure (adjusted hazard ratio [aHR]=1.34; 95% confidence interval [CI]: 0.87-2.10; p=0.18). Diabetes was associated with greater risk of catheter failure (aHR=1.88; 95% CI: 1.19-2.95; p=0.006), whereas higher age was associated with a lower risk of catheter failure (aHR per 10 years=0.83; 95% CI: 0.72-0.96; p=0.01). <\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p> This study demonstrates that there is no significant increase in bacteremia and subsequent catheter dysfunction rates after fibrin sheath disruption compared to simple over the wire exchange. These results are encouraging given the large numbers of patients utilizing tunneled catheters for initial hemodialysis access and the known rates of fibrin sheath formation leading to catheter failure. <\/jats:p><\/jats:sec>","DOI":"10.5301\/jva.5000301","type":"journal-article","created":{"date-parts":[[2014,9,8]],"date-time":"2014-09-08T12:40:34Z","timestamp":1410180034000},"page":"52-56","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":23,"title":["Tunneled Dialysis Catheter Exchange with Fibrin Sheath Disruption is not Associated with Increased Rate of Bacteremia"],"prefix":"10.1177","volume":"16","author":[{"given":"Amanda M.","family":"Valliant","sequence":"first","affiliation":[{"name":"Division of Nephrology, Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI - USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Muhammad K.","family":"Chaudhry","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI - USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexanders","family":"Yevzlin","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI - USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brad","family":"Astor","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI - USA"},{"name":"Department of Population Health Sciences, University of Wisconsin School of Medicine and Public Health, Madison, WI - USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Micah R.","family":"Chan","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI - USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2014,2,9]]},"reference":[{"key":"bibr1-jva.5000301","volume-title":"USRDS 2008 Annual Data Report: Atlas of chronic kidney disease and end-stage renal disease in the United States","author":"U.S. Renal Data System","year":"2008"},{"key":"bibr2-jva.5000301","first-page":"694","volume":"33","author":"Besarab A.","year":"2004","journal-title":"Dial Transplant."},{"key":"bibr3-jva.5000301","doi-asserted-by":"publisher","DOI":"10.2215\/CJN.01240308"},{"key":"bibr4-jva.5000301","doi-asserted-by":"publisher","DOI":"10.1053\/ajkd.2001.24526"},{"key":"bibr5-jva.5000301","doi-asserted-by":"publisher","DOI":"10.1016\/S0272-6386(96)90308-X"},{"key":"bibr6-jva.5000301","doi-asserted-by":"publisher","DOI":"10.1007\/s002700010042"},{"key":"bibr7-jva.5000301","doi-asserted-by":"publisher","DOI":"10.2215\/CJN.04840610"},{"key":"bibr8-jva.5000301","doi-asserted-by":"publisher","DOI":"10.2214\/ajr.179.2.1790357"},{"issue":"1","key":"bibr9-jva.5000301","first-page":"S248","volume":"48","author":"Vascular Access Work Group","year":"2006","journal-title":"Am J Kidney Dis."},{"key":"bibr10-jva.5000301","doi-asserted-by":"publisher","DOI":"10.1111\/sdi.12074"},{"key":"bibr11-jva.5000301","doi-asserted-by":"publisher","DOI":"10.2215\/CJN.01910507"},{"key":"bibr12-jva.5000301","doi-asserted-by":"publisher","DOI":"10.1097\/00003246-200204000-00033"},{"issue":"8","key":"bibr13-jva.5000301","first-page":"243","volume":"60","author":"Centers for Disease Control and Prevention (CDC)","year":"2011","journal-title":"MMWR Morb Mortal Wkly Rep."},{"key":"bibr14-jva.5000301","doi-asserted-by":"publisher","DOI":"10.1053\/j.ajkd.2013.03.011"}],"container-title":["The Journal of Vascular Access"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.5301\/jva.5000301","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.5301\/jva.5000301","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.5301\/jva.5000301","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,3,1]],"date-time":"2025-03-01T05:32:07Z","timestamp":1740807127000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.5301\/jva.5000301"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2014,2,9]]},"references-count":14,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2015,1]]}},"alternative-id":["10.5301\/jva.5000301"],"URL":"https:\/\/doi.org\/10.5301\/jva.5000301","relation":{},"ISSN":["1129-7298","1724-6032"],"issn-type":[{"value":"1129-7298","type":"print"},{"value":"1724-6032","type":"electronic"}],"subject":[],"published":{"date-parts":[[2014,2,9]]}}}