CE: continuing education article. Integration of palliative care for patients with stage 5 chronic kidney disease.

Patients with advanced chronic kidney disease (Stage 5 CKD) have palliative care needs similar to patients with cancer. The decision not to commence dialysis or to withdraw from active treatment can have a profound impact upon all those closely involved in the patient's care. It is essential that every effort is made to minimise the physical and psycho-social symptoms experienced by patients who require palliative care.

Vascular access management III: central venous catheters.

This third article, the final part of a Continuing Education (CE) series on Vascular Access Management for patients with end stage renal disease (ESRD), focuses on central venous catheters. CVCs are considered the last choice in vascular access due to the numerous complications associated with their use. This CE article explores the incidence and prevalence of central venous catheters within the context of international guidelines, type and design of central venous catheters, insertion procedure, strategies for preventing infection and complications associated with their use.

Vascular Access Management II: AVF/AVG cannulation techniques and complications.

This second article, in a three-part Continuing Education (CE) series on Vascular Access Management, focuses on cannulation issues including complications relating to arteriovenous fistula and arteriovenous graft access. The first article (McCann et al. 2008) gave an overview of vascular access while the final article in this series will focus on central venous catheters (CVC).

Venous needle dislodgement: how to minimise the risks.

Although haemodialysis (HD) has become a routine treatment, adverse side effects, and occasionally life threatening clinical complications, still happen. Venous needle dislodgment (VND) is one of the most serious accidents that can occur during HD. If the blood pump is not stopped, either by activation of the protective system of the dialysis machine or manually, the patient can bleed to death within minutes.

Vascular access management 1: an overview.

Vascular access for renal replacement therapy (RRT) is seen as one of the most challenging areas confronting the nephrology multidisciplinary team. The vascular access of choice is the arterio-venous fistula (AVF) followed by the arterio-venous graft (AVG) and central venous catheter (CVC). A successful vascular access programme requires forward planning ensuring that enough time is available for the preservation of the access site, its creation and maturation.