Central venous catheters and outcomes in hemodialysis

A significant proportion of incident and prevalent hemodialysis patients use central venous catheters for vascular access. These have been associated with high rates of access-related infection, suboptimal dialysis adequacy through mechanical dysfunction and central venous stenosis. Furthermore central venous catheters have been associated with poor patient survival and increased rates of hospitalisation. This chapter will provide an overview appraising all these key elements and discussing the clinical strategies employed in current practice to improve outcomes in catheter-dependent patients.