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2021, Number 1

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RCU 2021; 10 (1)

Depleted vascular tree in patient with advanced chronic kidney disease

Muradás AM, Cisneros MY, Moré MD, García RR, Aguilar QI, Díaz OY

Language: Spanish
References: 38
Page: 1-19
PDF size: 379.67 Kb.


ABSTRACT

Introduction: Vascular tree´s depletion in patients with end-stage chronic kidney disease is a serious condition that is secondary to the use of multiple central venous catheters as access routes for haemodialysis to face the impossibility of performance or dysfunction of an arteriovenous fistula. It occurs most often when non-tunneled venous catheters and subclavian veins are used as vessels of choice.
Objectives: Determine the incidence of patients with depleted vascular tree, the anatomical location most used for catheter placement, the percent success, and the complications of this procedure.
vMethods: An observational, descriptive, cross-sectional study was carried out, with all patients treated at the National Institute of Nephrology, who were placed with a central venous catheter tunneled for haemodialysis, in the period 2015-2018. Vascular ultrasound and fluoroscopy were used as imaging techniques in the course of the procedure. The data was collected on a form designed for this purpose.
Results: Occlusive central venous disease was developed in 15.5% of patients. In 84% of them, the procedure was successful. The catheter was most often placed in the femoral veins, and the main complication was arterial puncture.
Conclusions: The systematic use of central venous catheters as access routes for haemodialysis, rather than arteriovenous fistula, should be avoided to prevent depletion of vascular territory in the end-stage chronic renal patient.


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