Hemodialysis Risks with Central Venous Catheters—Will the Home Dialysis Push Increase the Dangers?

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Central venous catheters (CVCs) can pose significant risks for patients; thus, their use for chronic hemodialysis treatment is discouraged. The longer a hemodialysis patient receives treatment via a CVC, the greater the chances of a problem occurring. Unfortunately, many patients continue to receive hemodialysis treatment through a CVC well beyond the period when transition to another form of vascular access is recommended.

This fact, coupled with a recent push by the federal government in the United States toward home treatment for patients with kidney disease, raises concerns that an increasing number of patients with CVCs will receive hemodialysis in a home care setting, where caregivers may be ill-equipped to manage the risks.

1. For hemodialysis, a CVC can be used to provide immediate or emergency vascular access for a patient who does not have a more permanent form of access, such as an arteriovenous (AV) fistula or graft.

2. CVCs are typically placed through the jugular vein (or other large central...