Traditional and non-traditional strategies to optimize catheter function

Go with more flow

Michele H. Mokrzycki, Charmaine E. Lok

Research output: Contribution to journalArticle

31 Citations (Scopus)

Abstract

In the United States, over 340,000 patients have end-stage renal disease treated by hemodialysis (HD) and are dependent on a reliable vascular access. In over 80% of patients initiating HD, this access is the central venous catheter (CVC). Although the CVC has many advantages that make it desirable for dialysis initiationease of insertion, unnecessary maturation time, and availability for immediate useit is not without significant disadvantages. The substantial morbidity and mortality associated with CVC use has been well documented in the literature. 1, 2 Initiating and maintaining HD patients using a CVC is suboptimal from the perspective of both patient care and associated long-term costs. Yet, in the United States, the most common HD access-related event is replacement of any vascular access type with a CVC. 3 Although in recent years greater effort has be made to reduce CVC use, some patients are unable to have a functioning arteriovenous fistula or graft created due to exhaustion of vessels from previous permanent accesses or limiting comorbidities. In patients dependent on long-term CVC use, the primary problems are due to malfunction (poor flows) or infection. Catheter malfunction leads to inadequate dialysis, the need for costly and inconvenient intervention, and reduced quality of life. This review will focus on the etiology, prevention, and management of CVC-related malfunction.

Original languageEnglish (US)
Pages (from-to)1218-1231
Number of pages14
JournalKidney International
Volume78
Issue number12
DOIs
StatePublished - Dec 2010

Fingerprint

Central Venous Catheters
Catheters
Renal Dialysis
Blood Vessels
Dialysis
Arteriovenous Fistula
Chronic Kidney Failure
Comorbidity
Patient Care
Quality of Life
Morbidity
Transplants
Costs and Cost Analysis
Mortality
Infection

Keywords

  • catheter
  • fibrin sheath
  • hemodialysis
  • malfunction
  • thrombosis

ASJC Scopus subject areas

  • Nephrology

Cite this

Traditional and non-traditional strategies to optimize catheter function : Go with more flow. / Mokrzycki, Michele H.; Lok, Charmaine E.

In: Kidney International, Vol. 78, No. 12, 12.2010, p. 1218-1231.

Research output: Contribution to journalArticle

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