Long-term effect of an ethanol/sodium citrate locking solution on the mechanical properties of hemodialysis catheters

Purpose: To investigate the effect of a 30% ethanol/4% sodium citrate catheter locking solution on the mechanical properties of hemodialysis (HD) catheters over 36 weeks. Methods: Twenty-one HD catheters were used in this study. Three catheters, not exposed to locking solutions, underwent mechanical testing to determine baseline properties. Nine of the remaining 18 catheters were filled with normal saline and underwent mechanical testing in groups of three at 12, 24 and 36 weeks. Similarly, nine catheters were filled with the 30% ethanol/4% sodium citrate locking solution and tested in a similar manner. Results: The average force required to break the catheter lumens tended to be smaller in the catheters exposed to 30% ethanol/4% sodium citrate compared to saline controls at 12 and 24 weeks; however, there were no statistically significant differences between the groups after 36 weeks of exposure. The forces required to break these HD catheters are magnitudes greater than forces generated during a typical HD session. Conclusions: We conclude that the 30% ethanol/4% sodium citrate locking solution had an effect on the mechanical properties of the catheters investigated, but not to the degree that would preclude further in vivo investigation. Further studies are necessary to determine the safety and efficacy of this catheter locking solution. (J Vasc Access 2010; 11: 12-16)