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Lock Solutions in Dialysis

Ingredients, Efficacy, and Recommendations

Central-venous catheters (CVC) are commonly used for patients with permanent kidney failure. A catheter implanted into a central vein facilitates dialysis on a regular basis. Throughout this treatment, medical staff must minimise the risk of catheter-associated infections as far as possible. This is where TauroLock™ comes into effect: Combining taurolidine and citrate with heparin or urokinase, we offer lock solutions to meet the needs of dialysis patients:

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

On this site, you can read more about the usage and benefits of TauroLock™ solutions for permanent catheters required in dialysis therapy.

TauroLock™ Lock Solutions for Haemodialysis

Monitoring vascular access devices (VAD), you need to consider two main objectives: 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 a biofilm in CVCs during dialysis treatment. As a result, both objectives are met:

TauroLock™

kills more than 500 types of germs.

TauroLock™

helps to maintain an adequate blood flow rate.

This twofold efficacy relies on a combination of taurolidine (antimicrobial) and citrate (anticoagulant) as the basis for our catheter lock solutions applicable in dialysis. Depending on the patients’ individual conditions, there are different variations 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, 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 lock solution free of heparin, but supplemented by 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 will reliably prevent catheter occlusions and improve the patency rate. Furthermore, it prevents catheter-related infections.

TauroLock™ in Dialysis

Patients who suffer from HIT may also opt for another lock solution without heparin: TauroLock™ contains taurolidine and 4 % citrate. Apart from its bactericidal and fungicidal effect, it also prevents occlusions. Hence, patients remain protected from 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 must be administered by trained staff with medical expertise and experience. Based 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 may check the correct filling volume of each lumen as indicated on the device, or obtain instructions from the respective manufacturer.

Further Information

Feel free to download the instructions for use regarding different types of catheter lock solutions in dialysis: