the
ki ney
citizen
Long Term Dialysis Catheters:
A threat to your access;
A Threat to your Life
By
3
Steven Curtiss, M.D., F.A.C.S.
It is well established that the safest and most durable dialysis access is an arteriovenous (AV) fistula which is constructed by connecting a patient’s artery to vein. Unfortunately,
sometimes a patient’s renal disease is discovered when the
person is on the verge of dialysis. The progression of chronic
kidney disease is unpredictable. In these situations, there
may not be time for creation and maturation of
an AV fistula and if the patients’ preference is
for hemodialysis, the patient may require a dialysis catheter. Catheters are usually tunneled
under the skin of the chest wall into large veins
in the neck. Dialysis catheters can provide lifesaving emergency dialysis, but they also create
significant short-term and long-term problems
that patients should understand.
First, catheters carry a significant risk of life-threatening infection, because they provide a direct
pathway for bacteria to travel from the outside
world into the blood stream. In fact, one quarter
of dialysis patients with a catheter as long as one
year will have a life threatening infection. Since
these catheters have a large diameter, they often
lead to clotting or narrowing in the large v