A three-step approach to conversion of prevalent catheter-dependent hemodialysis patients to arteriovenous access.

Background And Objectives: Prevalent central venous catheter (CVC) rates among hemodialysis (HD) patients in Canada remain high. In October 2006, we implemented a three-step multidisciplinary quality improvement project in our in-centre HD unit. The primary objective was to convert 50% of suitable patients to arteriovenous fistulas (AVFs) or arteriovenous grafts (AVGs).

Prevention of catheter lumen occlusion with rT-PA versus heparin (Pre-CLOT): study protocol of a randomized trial [ISRCTN35253449].

Background: Many patients with end-stage renal disease use a central venous catheter for hemodialysis access. A large majority of these catheters malfunction within one year of insertion, with up to two-thirds due to thrombosis. The optimal solution for locking the catheter between hemodialysis sessions, to decrease the risk of thrombosis and catheter malfunction, is unknown.