Vascular access is the essential step in performing hemodialysis in uremic
patients. In the absence of a permanent and utilizable native arterio-venou
s fistula, the use of a tunnelled catheter makes dialysis therapy possible.
The Ash Split Cath, a recently introduced chronic hemodialysis catheter, w
as inserted in five patients (7.1 % of our prevalent dialysis population) b
ecause of repeated venous thrombosis in three patients and a poor venous tr
ee in two. The mean age of patients was 78 years +/- 7. The average blood f
low rate was 250 +/- 50 ml/minute and the mean venous pressure 140mm Hg +/-
35. Recirculation determined by low flux technique was less than 2 %. KT/V
calculated 3 months after the catheter placement was 1.2 +/- 0.02. During
the follow-up we did not document any infection of the exit site or related
to the catheter.
This device is simple to place, gives adequate dialysis treatment and is us
eful in geriatric dialyzed patients in whom the arterio-venous fistula can
no longer be used.