Central Venous Catheters for Hemodialysis-the Myth and the Evidence

Mohammad Ahsan Sohail; Tushar J Vachharajani; Evamaria Anvari

doi:10.1016/j.ekir.2021.09.009

Central Venous Catheters for Hemodialysis-the Myth and the Evidence

Kidney Int Rep. 2021 Oct 11;6(12):2958-2968. doi: 10.1016/j.ekir.2021.09.009. eCollection 2021 Dec.

Authors

Mohammad Ahsan Sohail¹, Tushar J Vachharajani^{2

3}, Evamaria Anvari^{2

3}

Affiliations

¹ Department of Internal Medicine, Cleveland Clinic, Cleveland, Ohio, USA.
² Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, Ohio, USA.
³ Department of Nephrology and Hypertension, Glickman Urological & Kidney Institute, Cleveland Clinic, Cleveland, Ohio, USA.

Abstract

Hemodialysis-central venous catheter (HD-CVC) insertion is a most often performed procedure, with approximately 80% of patients with end-stage kidney disease in the United States initiating kidney replacement therapy through a HD-CVC. Certain adverse events arising from HD-CVC placement, including catheter-related bloodstream infections (CR-BSIs), thrombosis, and central vein stenosis, can complicate the clinical course of patients and lead to considerable financial impact on the health care system. Medical professionals with different training backgrounds are responsible for performing this procedure, and therefore, comprehensive operator guidelines are crucial to improve the success rate of HD-CVC insertion and prevent complications. In this review article, we not only discuss the basic principles behind the use of HD-CVCs but also address frequently asked questions and myths regarding catheter asepsis, length selection, tip positioning, and flow rate assessment.

Keywords: central venous catheter; cuffed catheter; dialysis vascular access; hemodialysis; tunneled catheter.

Publication types

Review