Alternative methods of anticoagulation for dialysis-dependent patients with heparin-induced thrombocytopenia.

Dialysis patients who are continually exposed to heparin are at risk for heparin-induced thrombocytopenia (HIT). Heparin-induced antibodies have been reported to occur in 0-12% of hemodialysis (HD) patients. The diagnosis or suspicion of HIT in this patient population requires careful confirmation of the diagnosis and substitution of heparin with an alternate anticoagulant for dialysis.

Treatment approaches for infected hemodialysis vascular catheters.

Purpose Of Review: The focus of the review is to delineate protocols for catheter removal, catheter replacement and duration of therapy when a catheter-related infection occurs, and to demonstrate possible means of preventing such infections.

Recent Findings: The evidence supporting these views will be discussed in the light of our current practice.

Summary: Cuffed tunneled hemodialysis catheters have evolved for wide use as both temporary and semi-permanent hemodialysis access.