When is a catheter used for dialysis access?
A catheter is used for hemodialysis access when a patient requires dialysis and does not have a mature AV fistula or graft.
This circumstance can occur if either the patient needs dialysis acutely and does not have a functional AV fistula or graft in place, or if the patient has no suitable site to place an AV fistula or graft and thus uses the catheter for permanent hemodialysis access.
In observational studies, catheters are the least desirable, because patients with this access have a higher rate of morbidity and mortality than do patients with either AV grafts or AV fistulas.
Permanent catheters are usually placed into the superior vena cava through the internal jugular vein using a subcutaneous tunnel to decrease the risk of infection. Temporary catheters can be placed without a subcutaneous tunnel into an internal jugular vein or into a femoral vein.