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National guidelines recommend avoiding use of peripherally inserted central catheters (PICCs) in patients with advanced chronic kidney disease (CKD) — CKD stage 3b or higher, or estimated glomerular filtration rate (GFR) of <45 mL/minute/1.73 m2 — so that vascular access can be preserved for future hemodialysis (HD) needs. To evaluate whether guideline recommendations are followed, investigators conducted a prospective cohort study of >20,000 hospitalized patients who had PICCs placed during hospital stays at 52 Michigan hospitals during 3 years.
One fourth of patients who had PICCs placed had CKD stage 3b or higher; one in seven PICCs were placed in patients receiving hemodialysis. Multilumen PICCs were placed more frequently than single-lu…