Trends in Central Catheter Use for Hemodialysis

Clinical Takeaway

: In the United States, patients are increasingly using central venous catheters for hemodialysis, despite longstanding initiatives to reduce their use.

Context

Despite guidelines recommending placement of an arteriovenous fistula or graft, many patients with kidney failure start hemodialysis with a central venous catheter (CVC). Though easy to place, CVCs are associated with frequent dysfunction and higher risks for bacteremia and endocarditis, and national quality metrics and dialysis unit reimbursement cuts are tied to excessive use of CVCs. Here, researchers examined recent trends in vascular access methods in all U.S. patients (>500,000) initiating hemodialysis for kidney failure.

Key Results

Between 2016 and 2022, the proportion of patients starting hemodialysis with a CVC steadily increased from 62% to 74%.
Among patients who began hemodialysis with a CVC only, the proportion who receive…

Reviewing Author

Meghan Sise, M.D., M.S.

Disclosures

Consultant/Advisory BoardMedibeacon; Otsuka; Relay Tx; Merida Bioscience; Biogen; Novartis; Vera; Alpine Immune Science

Speaker's BureauCurio; TD Cowen; Medintelligence/Reach MD

Grant/Research SupportMerck Sharp & Dohme LLC; Gilead Sciences, Inc.; AstraZeneca AB; Amgen, Inc.; Genentech, Inc.; Trustees of Columbia University in the City of New York; Syneos Health, LLC; Novartis Pharmaceuticals Corporation; Cabaletta Bio, Inc.

Editorial BoardsKidney International Reports; American Journal of Kidney Diseases

Leadership Positions in Professional SocietiesAmerican Society of Nephrology; National Kidney Foundation