An arteriovenous access is preferred for hemodialysis, but the use of tunneled, cuffed catheters may be necessary in the inpatient setting with acute kidney injury when immediate hemodialysis is required and fistula immaturity or access complications are present. Care of the dialysis central venous catheter is paramount in the prevention of central line-associated bloodstream infections in acutely ill individuals. One institution's approach to hemodialysis central venous catheter care and a quality improvement projectfor selecting tunneled catheters will highlight their changing practice.
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