Table 1.

Criteria for participating in the Hemodialysis Infection Prevention Protocols Ontario—Shower Technique (HIPPO-ST): pilot randomized trial

Inclusion criteria

1. English speaking

2. Age ≥18 years

3. Required a catheter for vascular access: a) end-stage kidney disease (ESKD) without a functioning surgically created access; b) ESKD patient whose peritoneal dialysis problems required transfer to HD for an anticipated prolonged period

4. Was willing and able to take a shower as the standard form of body cleansing if randomized to HIPPO-ST

5. Trisodium citrate (4%) as standard catheter locking solution

6. Catheter has been in situ for >6 weeks

Exclusion criteria

1. Acute kidney failure, likely to be reversible with recovery of renal function

2. Nontunneled catheter

3. Antibiotic use by any route in the week prior to enrolling in the study, including intranasal mupirocin

4. On immunosuppressant therapy

5. Use of the catheter for purposes other than access for HD (e.g., TPN)

6. Involvement in another interventional study related to their vascular access

7. Catheter or patient life expectancy <6 months (e.g., active malignancy; serious comorbidity such as hepatic failure)

8. Routine use of TPA or antibiotic as a locking solution

9. Catheter insertion in location other than the neck/chest region (internal jugular or subclavian acceptable)

ESKD, end-stage kidney disease; HD, hemodialysis; TPA, tissue plasminogen activator; TPN, total parenteral nutrition.