Vascular access in acute renal failure

Today, central venous access catheters play an important role in the treatment and management of many dialysis patients. Their use and care may influence the patient's overall outcome. Therefore, it is critical to have a thorough knowledge of the vascular anatomy, types of catheters, placement techniques and maintenance and management of complications. The incidence nowadays of acute renal failure in intensive care patients is reported as high as 25%. Acute renal failure is one of the few causes of organ failure in which complete recovery is possible, provided the patient survives the associated comorbid conditions. There are various extracorporeal dialysis techniques available to treat this category of patients using mostly a central dialysis catheter as vascular access. It is important to select carefully the type of catheter and to create a specific vascular access system in order to be able to perform the selected dialysis technique in the most optimal efficient conditions. Any inadequacies of access will create dialysis insufficiency leading to more comorbid conditions and even higher mortality. In this article, we will describe the different possibilities as well as the nursing management of that type of vascular access in patients with acute renal failure.