Korean J Nephrol.  2005 Nov;24(6):895-901.

The Reasons for Use of Temporary Catheter Instead of Arteriovenous Fistula at the Start of Chronic Hemodialysis Therapy

Affiliations
  • 1Department of Internal Medicine, Daegu Fatima Hospital, Daegu, Korea. shkim@fatima.or.kr

Abstract

PURPOSE
Placement of an arteriovenous fistula (AVF) before initiation of chronic hemodialysis (HD) is recommended to avoid the use of a dialysis catheter. However, many patients use temporary catheter at the start of HD for many reasons. We conducted a study to examine the reasons for use of temporary catheter instead of AVF at initial HD therapy. METHODS: We investigated 61 chronic renal failure (CRF) patients who started HD from January 2001 to August 2004 at Daegu Fatima Hospital. Fourty one of them used temporary catheter (catheter group) and 20 used AVF (AVF group) at initial HD. The causes of CRF, clinical presentation at initial HD, reasons that required start of HD and reasons for use of temporary catheter were investigated. RESULTS: The reasons that required start of HD were dyspnea (23), uremic symptoms (11), severe edema (4) and metabolic abnormalities (3) in catheter group and uremic symptoms (8), progression of CRF with minimal uremic symptoms (8) in AVF group. Those causes of unpreparedness of AVF in catheter group were delayed referral (12), rapid progression of CRF (12), unawareness of CRF (10), and noncompliance (7). The systolic and diastolic blood pressure were higher in catheter group than AVF group (171.3+/-33.5 vs 146.0+/-18.0 mmHg, 94.0+/-18.5 vs 80.6+/-10.8 mmHg, respectively). Serum albumin level was lower (3.0+/-0.6 vs 3.4+/-0.7 g/dL) and serum phosphorus level was higher (6.8+/-1.9 vs 5.7+/-1.7 mg/dL) in catheter group. CONCLUSION: To avoid temporary vascular catheter, early diagnosis of CRF, early referral to nephrologist and preparation of AVF is essential.

Keyword

Temporary catheter; Arteriovenous fistula; Emergency hemodialysis

MeSH Terms

Arteriovenous Fistula*
Blood Pressure
Catheters*
Daegu
Dialysis
Dyspnea
Early Diagnosis
Edema
Humans
Kidney Failure, Chronic
Phosphorus
Referral and Consultation
Renal Dialysis*
Serum Albumin
Vascular Access Devices
Phosphorus
Serum Albumin
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