2024/08/16 by Bernd Schröppel, Lucas Bettac, Lena Schulte‐Kemna +1 · 1 voice
Health Professions · Medicine · #Acute Kidney Injury Research #Central Venous Catheters and Hemodialysis #Vascular Procedures and Complications
paper · pdf · doi:10.1093/ndt/gfae181
openalex publication_date 2024/08/16 · openalex created_date 2024/08/19 · openalex updated_date 2026/08/04
While the native arteriovenous fistula remains the first choice in vascular access for most haemodialysis patients, tunnelled haemodialysis catheters (tHDCs) continue to be an option in selected patients. Since timely access to vascular surgery-due to delayed referral or resource limitations-is not always possible, nephrologists have to become more actively involved in planning, creation and monitoring of vascular access. Moreover, this approach could also strengthen patient-centred care in nephrology. This article reviews the current standard in tHDC creation, patient selection and strategies to mitigate the risk of infectious complications and catheter thrombosis. Presentation of novel developments in catheter placement with ultrasound-guided or electrocardiogram-guided positioning, their benefits and possible disadvantages emphasizes the complexity of vascular access planning. We offer an approach for the choice of insertion method, depending on selected side and existing resources and focus on the necessity and required resources of 'interventional nephrology' training programs.