Pulsatile flushing to reduce blockage of tunneled dialysis catheters
Exploring the Effectiveness of Pulsatile Flushing Technique in Reducing Blockage of the Tunnelled Central Venous Access Device Among Haemodialysis Patients in Multiple Renal Centres in Hong Kong: A Cluster Non-Randomised Controlled Trial Study
This compares two pulsatile flushing methods to see if they reduce blockage of tunneled dialysis catheters in people on haemodialysis.
Quick facts
| Phase | Not applicable |
|---|---|
| Study type | Interventional |
| Enrollment | 591 (estimated) |
| Ages | 18 Years and up |
| Sex | All |
| Sponsor | Queen Elizabeth Hospital, Hong Kong Academic / other |
| Locations | 1 site (Kowloon) |
| Trial ID | NCT07567456 on ClinicalTrials.gov |
What this trial studies
This is a prospective, parallel, cluster non-randomised controlled trial across 14 renal units in Hong Kong enrolling 591 haemodialysis patients with tunneled central venous access devices. Renal-unit clusters are assigned to one of three arms: pulsatile flushing with a 0.4 second pause (IG-A), pulsatile flushing with a 1 second pause (IG-B), or standard bolus flushing (control). The primary outcome is time-to-event blockage of the T-CVAD, analyzed using survival analysis to compare device patency between arms. Findings are intended to identify the most effective flushing interval and inform Hospital Authority best-practice protocols for catheter maintenance.
Who should consider this trial
Good fit: Ideal candidates are haemodialysis patients with a tunneled central venous access device who receive care at the participating Hospital Authority renal units and can provide informed consent in Chinese or English.
Not a fit: Patients with non-tunneled catheters, occlusions from mechanical causes or fibrin sheaths requiring surgical intervention, temporary dysfunctions resolved by repositioning, or those unable or unwilling to consent are unlikely to benefit from the flushing techniques tested.
Why it matters
Potential benefit: If successful, the preferred pulsatile flushing technique could reduce catheter blockages, lower the need for interventions and improve long-term dialysis access reliability.
How similar studies have performed: Pulsatile flushing methods have shown benefits in some peripheral and central catheter maintenance studies, but high-quality data specifically for tunneled haemodialysis catheters are limited, so this application is relatively novel.
Eligibility criteria
Show full inclusion / exclusion criteria
Inclusion Criteria: * Patients undergoing HD treatment with Tunnelled Central Venous Access Device (T-CVAD) in the above collaborators under the Hospital Authority * Able to understand spoken and written Chinese or English Exclusion Criteria: * Patients with Non-Tunnelled Central Venous Access Device (NT-CVAD) * Temporary dysfunction (e.g., kicking of the catheter) resolved with repositioning * Confirmed case of fibrin sheath occlusion which can only be resolved through surgical intervention * Non-thrombotic occlusion due to mechanical causes (e.g., catheter malposition) * Patient declined or incompetent to provide written informed consent.
Where this trial is running
Kowloon
- Queen Elizabeth Hospital — Kowloon, Hong Kong (Recruiting)
Study contacts
- Study coordinator: SUNG Ka Ming Dorothy, KCC NC (Renal Care)
- Email: bskmd01@ha.org.hk
- Phone: 852-3506
How to participate
- Review the eligibility criteria above with your treating physician.
- Visit the official trial page on ClinicalTrials.gov for the most current contact information and recruitment status.
- Contact the listed study coordinator or principal investigator to request pre-screening. Pre-screening is free and never obligates you to enroll.