Blood flowrate and dialysis adequacy in patients with permanent central venous catheters

Vascular access efficiency is a major determinant of an adequate dialytic treatment and reports from literature indicates a growing interest in the field of central venous catheterisation as permanent vascular access for hemodialysis. The main reasons are the continuous improvement in design and biomaterials along with the increased number of patients with failure of their vascular beds. In this paper it is presented and commented a series of negative crucial factors which can reduce the quality of the hemodialysis treatment: the problem of re-circulation and the catheter related (and the patient related) causes of inadequate flowrate. Finally the Authors conclude with a short presentation of their clinical experience in the field.