Hemodialysis Access Care

The catheters used for hemodialysis are small tubes that are placed under the skin. They are considered the least desirable form of dialysis access. Catheters come in two ways: a short-term (non-tunneled) and longer-term (tunneled) form. Its best use is to provide limited access to dialysis for patients whose kidney function is expected to improve. It is also used on patients whose kidney function is not likely to improve but who have a graft or fistula in place as they are awaiting it to develop. An interventional radiologist inserts a catheter through one of the large veins, usually the jugular, into larger veins that are located in the center of the chest near the heart. This procedure lasts less than an hour and can be done as an outpatient. The best outcomes with catheter placement are achieved through the use of imaging guidance, including ultrasound, to inject a needle into the vein and X-rays to lead the accurate placement of the catheter. They hold the advantage of being able to be used for dialysis instantly after they are placed. Patients are also fond of them because the needle sticks are not necessary to remove and replace blood during dialysis, which is common with graft or fistula procedures. However, catheters come with their set of significant disadvantages and challenges,