Hemodialysis catheter care

Rosenblum A, et al Hemodialysis catheter care strategies a cluster-randomized quality improvement initiative. Am J Kidney Dis 2014 63 259-267. 

Maki DG, et al A novel antimicrobial and antithrombotic lock solution for hemodialysis catheters a multi-center, controlled, randomized trial. Crit Care Med 2011 39 613-620. 

High doses of epoetin in children undergoing long-term hemodialysis is associated with increased heparin requirements during hemodialysis, suggesting that careful monitoring of thrombotic events, especially in small children who need catheters for hemodialysis access, is warranted (114). 

Dialysis vascular access is currently the lifeline for hemodialysis patients. Unfortunately, due to the many complications associated with dialysis vascular access, it is also the Achilles heel of hemodialysis. A relatively ignored aspect of dialysis vascular access pertains to patient safety. The first part of this chapter will describe patient safety issues in the traditional context of arteriovenous fistulas (AVFs), arteriovenous grafts (AVGs) and tunneled central venous catheter (tCVC). In the second half of this chapter, however, we will make the case that a nontraditional approach which emphasizes (a) individualization of care, and (b) patient preferences and patient involvement maybe our best opportunity to improve patient safety in hemodialysis patients. 

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