Central Venous Catheters in hemodialysis: an actual conundrum without solutions.
Vascular access maintenance is a major problem for adequate care of End Stage Renal Disease. An ideal access delivers an adequate flow rate for the HD prescription, remains usable for an indefinitely long period of time, and has a low complication rate. The native arteriovenous fistula (AVF) remains the best access, but this option may be impraticable in many conditions. This paper describes why to use CVC, where CVC can be positioned and how CVC infections can be prevented. Also today, vascular access in hemodialysis remains the conundrum without solution, but it is often necessary and remains the only possible venous access in a particular category of patients.
Di Iorio
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Nephrology and Dialysis Unit, 'A. Landolfi' Hospital, Solofra (AV) - Italy.