[Hemodialysis: vascular access with double lumen catheter]

We evaluated the results of hemodialysis performed with 106 double lumen catheters in 87 patients (mean age 52, range 10-82). 46 patients had chronic and 38 acute renal failure; 2 had respiratory distress syndrome and one refractory heart failure. Catheter flow ranged from 100 to 250 ml/min (mean 207) and effective clearance from 64 to 171 ml/min (mean 125). Only one catheter was used in 75 patients (86%), 2 in 7 and more than 2 in 5. Causes of failure included inadequate flow (9), coagulation (6) and displacement (4). In nine instances, severe complications developed: sepsis (3), local infection (4), hematoma (1) and vagal reaction (1). Three patient with catheters located in the subclavian vein developed vein stenosis, requiring angioplasty in 2 and graft in 1. Thus, double lumen catheter is easy to place and helps preserve future vascular sites in chronic hemodialysis.