Frequency of Deep Venous Thrombosis in Patients Undergoing Dialysis Via Non-Tunneled Femoral Double Lumen Catheters

Abstract

Background: Haemodialysis is a critical modality of renal replacement therapy, but temporary non-tunnelled femoral catheters remain widely used in urgent or resource-limited settings despite their association with complications such as deep venous thrombosis (DVT). Evidence from South Asia on the burden and predictors of catheter-related thrombosis is limited, restricting development of preventive guidelines. Objective: To determine the frequency of femoral catheter-related DVT and identify associated risk factors among patients undergoing haemodialysis. Methods: This cross-sectional study was conducted at the Department of Nephrology, Khyber Teaching Hospital, Peshawar, from March to June 2025. A total of 173 patients aged 20–60 years undergoing dialysis via femoral double-lumen catheters for more than 24 hours were consecutively recruited. Duplex ultrasonography confirmed DVT diagnosis. Demographic, clinical, and procedural variables were recorded and analysed using chi-square/Fisher’s exact tests and binary logistic regression. Results: Thrombosis was confirmed in 13 patients (7.5%), with left femoral involvement in 61.5%, right sided in 30.8%, and bilateral in 7.7%. No significant associations were observed with age (p=0.72), gender (p=0.38), BMI (p=0.81), or dialysis indication (p=0.64). Catheter dwell time ≥6 days was strongly associated with DVT (24.3% vs 2.9%; adjusted OR 9.8, 95% CI 2.5–37.6, p=0.001). Conclusion: Femoral catheter-related DVT occurred in 7.5% of patients, with catheter dwell time beyond six days as the only independent predictor. Early transition to permanent vascular access is essential to reduce thrombotic complications.