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Catheter access for hemodialysis: an overview

D W Butterly1, S J Schwab

  • 1Division of Nephrology, Department of Medicine, Duke University Medical Center, Durham, North Carolina 27710, USA.

Seminars in Dialysis
|February 20, 2002
PubMed

Insights

Tunneled dialysis catheters offer convenient central circulatory access for hemodialysis but increase risks of infection, vein stenosis, and mortality. Arteriovenous fistulae and grafts remain preferred for long-term, safer hemodialysis vascular access.

Area of Science:

  • Nephrology
  • Vascular Surgery
  • Infectious Diseases

Background:

  • Hemodialysis necessitates reliable central circulatory access.
  • Arteriovenous fistulae (AVF) and arteriovenous grafts (AVG) are traditional long-term access methods.
  • Tunneled dialysis catheters (TDCs) are increasingly used for chronic hemodialysis.

Purpose of the Study:

  • To evaluate the role and risks of TDCs in chronic hemodialysis.
  • To compare TDCs with AVF and AVG for long-term vascular access.

Main Methods:

  • Review of current literature on hemodialysis vascular access.
  • Analysis of complication rates associated with TDCs versus AVF/AVG.
  • Assessment of patient outcomes related to different access modalities.

Main Results:

  • TDCs offer immediate usability and ease of placement.
  • TDCs are associated with significantly higher risks of bacteremia.
  • TDCs increase the likelihood of central vein stenosis and mortality compared to AVF/AVG.

Conclusions:

  • While convenient, TDCs pose substantial risks for chronic hemodialysis patients.
  • AVF and AVG remain superior for long-term hemodialysis due to lower complication rates.
  • Careful consideration of risks versus benefits is crucial when selecting TDC for maintenance hemodialysis.

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