Safety and efficacy of taurolidine/urokinase versus taurolidine/heparin as a tunneled catheter lock solution in hemodialysis patients: a prospective, randomized, controlled study.
Al-Ali F, Hamdy AF, Hamad A, Elsayed M, Iqbal ZZ, Elsayed A, Ibrahim R, Tolba H, Buanan H, Fawzy A. NDT 2017:1-7.
Comparison of the TauroLock™ 2+1 protocol (TauroLock/U: TauroLock™-Hep500 twice weekly and TauroLockTM-U25.000 once weekly) versus TauroLock™-Hep500 (TauroLock/Hep).
The study was performed as a prospective, randomized, controlled trial in hemodialysis patients using newly inserted tunneled central venous catheters (in total 15,690 catheter days). Follow up was 6 months.
- Catheter removal:
The total number of catheter exchange (due to acute thrombosis and CRBSI) was significantly lower in the TauroLock/U group (P=0.028).
- Catheter infection:
The overall CRBSI rate was 0.3/1000 catheter days in the TauroLock/Hep group versus 0.08/1000 catheter days in the TauroLock/U group.
- Patency, blood flow:
Repeated use of rt-PA was significantly less frequent in the TauroLock/U group (P=0.006) although the number of patients requiring rt-PA was not different.
Higher blood flow rates (BFR) were noted in the TauroLock/U group.
- Dialysis adequacy:
Improvements in dialysis adequacy (measured as Kt/V) were noted in the TauroLock/U-Group, although the differences were not uniformly significant.
TauroLock™-U25.000 is a safe and effective catheter lock solution in dialysis catheters.
This trial supports evidence of other randomized studies in dialysis that use of TauroLock™-Hep500 leads to very low CRBSI-rates.
The combination of TauroLock™-Hep500 (twice a week) and TauroLock™-U25.000 (once a week) in a so-called “2+1 protocol” provides excellent results regarding catheter exchange, patency, and CRBSI rate.
The data on rt-PA use show that TauroLock™-Hep500 already maintains a good patency in the majority of patients. Only a small number of patients (6 from 93 patients) required rt-PA significantly more frequently. For these patients with a high risk for occlusion we recommend the “2+1 protocol”. For a thrice weekly use of TauroLock™-U25.000 we expect a further improvement.