Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2021 Oct 11;6(12):2958-2968.
doi: 10.1016/j.ekir.2021.09.009. eCollection 2021 Dec.

Central Venous Catheters for Hemodialysis-the Myth and the Evidence

Mohammad Ahsan Sohail  1 , Tushar J Vachharajani  2   3 , Evamaria Anvari  2   3
Affiliations
Review

Central Venous Catheters for Hemodialysis-the Myth and the Evidence

Mohammad Ahsan Sohail et al. Kidney Int Rep. .

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.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Tunneled hemodialysis catheter tips. (a) Split tip with preformed curved tips. (b) Split tip standard. (c) c1/c2—step tip. (d) d1/d2—symmetric tip with side slots. (e) Symmetric tip with side holes. (f) Dual catheter (e.g., Tesio twin catheter).
See this image and copyright information in PMC

References

    1. Lok C.E., Huber T.S., Lee T., et al. KDOQI Clinical Practice Guideline for vascular access: 2019 update [published correction appears in. Am J Kidney Dis. 2021;77:551] Am J Kidney Dis. 2020;75(suppl 2):S1–S164. doi: 10.1053/j.ajkd.2019.12.001. - DOI - PubMed
    1. Al-Balas A., Lee T., Young C.J., Kepes J.A., Barker-Finkel J., Allon M. The clinical and economic effect of vascular access selection in patients initiating hemodialysis with a catheter. J Am Soc Nephrol. 2017;28:3679–3687. doi: 10.1681/ASN.2016060707. - DOI - PMC - PubMed
    1. Al-Balas A., Shariff S., Lee T., Young C., Allon M. Clinical outcomes and economic impact of starting hemodialysis with a catheter after predialysis arteriovenous fistula creation. Am J Nephrol. 2019;50:221–227. doi: 10.1159/000502050. - DOI - PubMed
    1. Saran R., Robinson B., Abbott K.C., et al. US renal data system 2019 annual data report: epidemiology of kidney disease in the United States. Am J Kidney Dis. 2020;75(1 suppl 1):A6–A7. doi: 10.1053/j.ajkd.2019.09.003. - DOI - PubMed
    1. Astor B.C., Eustace J.A., Powe N.R., et al. Timing of nephrologist referral and arteriovenous access use: the CHOICE study. Am J Kidney Dis. 2001;38:494–501. doi: 10.1053/ajkd.2001.26833. - DOI - PubMed

LinkOut - more resources