Indications and Complications of Tunnelled Haemodialysis Catheters: A Single-Centre Retrospective Study of 114 Patients

Background: Tunnelled haemodialysis catheters provide vascular access when an arteriovenous fistula (AVF) is unavailable, immature, or temporarily unusable.We evaluated indications, insertion sites, complications, and access transition in a Moroccan tertiary vascular surgery centre.Methods: This retrospective single-centre study included unique patients undergoing tunnelled haemodialysis catheter placement between January 2020 and August 2024.After data cleaning, one confirmed duplicate record was consolidated, yielding 114 unique patients.The patient was the unit of analysis.Categorical outcomes were reported as counts and percentages, with Wilson 95% confidence intervals (CIs) for complication proportions.Exploratory associations with delayed complications were assessed using two-sided Fisher exact and Mann-Whitney U tests; Holm correction was applied across six prespecified comparisons.Results: The mean age was 50.7 ± 15.8 years and 68 patients (59.6%) were men.Diabetes was present in 49 (43.0%),hypertension in 42 (36.8%),and cardiovascular disease in 17 (14.9%).Awaiting AVF creation was the leading indication (61/114, 53.5%).The right internal jugular vein was used in 110 patients (96.5%).Immediate bleeding occurred in 6 patients (5.3%; 95% CI 2.4-11.0%).Delayed complications occurred in 20 (17.5%; 95% CI 11.7-25.6%):thrombosis in 11 (9.6%), infection in 6 (5.3%), and post-dialysis bleeding in 3 (2.6%).Patients with delayed complications were older than those without delayed complications (median 57.5 vs 48.0 years; p=0.007;Holm-adjusted p=0.043).AVF maturation was the recorded reason for ending catheter use in 93 patients (81.6%).Conclusion: Tunnelled catheters were used predominantly as bridging access while patients awaited AVF creation or maturation.Thrombosis was the most frequent delayed complication.Older age was associated with delayed complications in this exploratory analysis, but the small number of events and retrospective design require cautious interpretation.Standardised event definitions and dated catheter follow-up would strengthen future surveillance.