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Lock solutions in dialysis

Ingredients, efficacy, recommendations

Central-venous catheters (CVC) are commonly used for patients with permanent kidney failure. As they undergo haemodialysis on a regular basis, medical staff must minimise the risk of catheter-related infections as far as possible. This is where TauroLock™ comes into play. Combining taurolidine and citrate with heparin or urokinase, we have developed lock solutions to meet the needs of dialysis patients:

  • protection against infections
  • prevention of blood clotting
  • safe application in various contexts

TauroLock™ lock solutions for haemodialysis

There are two major risks when using vascular access devices (VAD): First, the catheter must not come into contact with bacteria and fungi. Second, it is essential to avoid blood clotting. Our lock solutions prevent the formation of biofilm in CVCs during dialysis treatment to meet both objectives:

Taurolidine

kills more than 500 types of germs.


Citrate, heparin, and urokinase

maintain an adequate blood flow rate.


TauroLock™ solutions are based on a combination of taurolidine and citrate, complemented by heparin or urokinase. Therefore, they have an antimicrobial, anticoagulant, and even thrombolytic effect. Depending on the patient's individual condition, there are different variants available.

TauroLock™-Hep500 in dialysis

Dialysis patients are prone to develop higher occlusion rates. We recommend a lock solution that includes the anticoagulant heparin: TauroLock™-HEP500 contains 500 IU of heparin per ml, in addition to taurolidine and 4 % citrate. This composition reduces occlusion rates as efficiently as 5,000 IU/ml of heparin. At the same time, it prevents catheter-related infections. 

TauroLock™-U25.000 in dialysis

Patients with a propensity for high occlusion rates and HIT (heparin-induced thrombocytopenia) will benefit from a heparin-free lock solution with the thrombolytic agent urokinase. TauroLock™-U25.000 contains taurolidine, 4 % citrate, and 25,000 IU of urokinase. When used regularly (e.g. weekly) as a prophylaxis in dialysis, this solution reliably prevents catheter occlusions and improves the patency rate. Likewise, it prevents catheter-related infections. 

TauroLock™ in dialysis

Patients who suffer from HIT might opt for another lock solution without heparin: TauroLock™ contains taurolidine and 4 % citrate. Apart from its bactericidal and fungicidal effect, it also prevents occlusions: Patients remain protected against infections and blood clotting.

All ingredients named above have been approved and recommended in current guidelines (ERBP, DGfN, UK Ren. Ass., SF2H, and other national guidelines).

Please note that all TauroLock™ products are to be administered by trained staff with medical expertise and experience. On this premise, we advise the following procedure:

1. Before dialysis

  • Remove TauroLock™/TauroLock™-Hep500/TauroLock™-U25.000 and residual blood from the catheter.
  • Flush all lumens of the access device with 10 ml of saline and a syringe according to the push-pause technique.
  • Start dialysis.

 

2. After dialysis

  • Flush both lumens with 10 ml of saline using the push-pause technique.
  • Gently tap the ampoule’s neck to remove the lock solution.
  • Tilt the ampoule so that you can see a white dot on top and quickly break off the neck.
  • When using TauroLock™-U25.000:
    Reconstitute the urokinase that is delivered in a separate vial with TauroLock™ withdrawn from the ampoule. TauroLock™-U25.000 must be used immediately after reconstitution.
  • Draw the TauroLock™ solution from the ampoule into a sterile syringe.

 

3. In-between treatment sessions

  • To ensure the solution’s prophylactic efficacy, slowly instil a volume sufficient to fill the entire lumens of the VAD.
  • You can check the correct filling volume of each lumen as indicated on the device or based on the manufacturer’s instructions.

More information

Download materials on lock solutions in dialysis

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