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Central venous catheters are used for vascular access in patients who are undergoing hemodialysis, but about 50% of catheters fail within 1 year, usually due to thrombosis. Catheter failure is associated with higher incidences of infection, hospitalization, and death, as well as with higher costs. Various agents (locking solutions) are instilled routinely into central venous catheters after dialysis to lower risk for catheter malfunction and bacteremia, but the most effective approach is unknown.
In an industry-sponsored Canadian study, 225 patients who were undergoing long-term thrice-weekly hemodialysis with newly inserted central venous catheters were randomized to a catheter locking regimen of heparin alone (5000 units 3 times weekly) or…