Treatment approaches for infected hemodialysis vascular catheters.
OBJECTIVE
The focus of the review is to delineate protocols for catheter removal, catheter replacement and duration of therapy when a catheter-related infection occurs, and to demonstrate possible means of preventing such infections.


RESULTS
The evidence supporting these views will be discussed in the light of our current practice.


CONCLUSIONS
Cuffed tunneled hemodialysis catheters have evolved for wide use as both temporary and semi-permanent hemodialysis access. The primary barriers to long-term catheter use are catheter-related infection and catheter dysfunction. Catheter-related infection has emerged as the primary barrier to long-term catheter use. Under both circumstances, however, catheter replacement or some form of intervention is often needed. Because of this, catheters are often removed and replaced, but the duration of therapy and the timing of replacement of these catheters is not completely clear.
Kovalik
Eugene C
EC
Division of Nephrology, Department of Medicine, Duke University Medical Center, Durham, North Carolina 27710, USA. koval001@mc.duke.edu
Schwab
Steve J
SJ
D016470:Bacteremia / Q000209:etiology; D002404:Catheterization / Q000009:adverse effects*; D003428:Cross Infection / Q000382:microbiology / Q000473:pathology / Q000628:therapy*; D006801:Humans; D006435:Renal Dialysis / Q000009:adverse effects*; D012307:Risk Factors