Central venous disease in hemodialysis patients

Area of Science:

• Vascular Surgery
• Nephrology
• Interventional Radiology

Background:

• Central venous disease (CVD) presents significant treatment challenges, potentially leading to hemodialysis vascular access abandonment and life-threatening complications.
• The increasing prevalence of chronic kidney disease (CKD), particularly with an aging population, results in more frequent use of peripherally inserted central catheters (PICCs).
• PICCs can lead to CVD, damaging critical veins like the basilic vein, which is essential for arteriovenous fistula (AVF) creation in end-stage renal disease (ESRD) patients.

Purpose of the Study:

• To review the pathophysiology, clinical features, and advanced treatment options for central venous disease (CVD).
• To highlight the critical role of prevention strategies for CVD.
• To emphasize the impact of central venous catheter (CVC) use on CVD development.

Main Methods:

• Literature review focusing on central venous territories, pathophysiology, clinical presentation, and treatment of CVD.
• Analysis of risk factors associated with central venous catheter (CVC) insertion and duration of use.
• Discussion of preventative measures against CVD, particularly in the context of CKD and PICC usage.

Main Results:

• Central venous catheter (CVC) insertion and prolonged use are identified as primary risk factors for CVD.
• Peripherally inserted central catheters (PICCs) pose a risk to central veins, including the basilic vein, crucial for AVF creation in ESRD patients.
• Minimizing central vein catheterization and its duration is crucial for reducing CVD incidence.

Conclusions:

• Prevention of central venous disease (CVD) is paramount due to treatment difficulties and potential severity.
• Reducing the necessity and duration of central venous catheter (CVC) use is a key preventative strategy.
• Understanding CVD pathophysiology and risk factors is essential for effective management and prevention in CKD patients.