Central venous disease in hemodialysis patients
Hoon Suk Park1 , Joonsung Choi2 , Jun Hyun Baik2
1Division of Nephrology, Department of Internal Medicine, Eunpyeong St. Mary’s Hospital, School of Medicine, The Catholic University of Korea, Seoul, Korea
2Department of Radiology, St. Vincent’s Hospital, School of Medicine, The Catholic University of Korea, Suwon, Korea
Correspondence to: Jun Hyun Baik
Department of Radiology, St. Vincent’s Hospital, The Catholic University of Korea, 93 Jungbu-daero, Paldal-gu, Suwon 16247, Korea.
E-mail: jhbaik@catholic.ac.kr

Edited by Jeonghwan Lee, Seoul National University, Seoul, Korea
Contributed by the Korean Society of Diagnostic and Interventional Nephrology
Received: March 6, 2019; Revised: May 31, 2019; Accepted: May 31, 2019; Published online: August 7, 2019.
© The Korean Society of Nephrology. All rights reserved.

This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc-nd/4.0/), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Central venous disease (CVD) is difficult to treat and often resistant to treatment. In CVD, hemodialysis vascular access should sometimes be abandoned, or in serious cases, the patient's life may be threatened. Therefore, prevention is ideal. However, as the prevalence of chronic kidney disease (CKD) has increased steadily with population aging, CKD patients with a peripherally inserted central catheter (PICC) are encountered frequently. PICCs can cause CVD, and the basilic vein, which is regarded as the important last option for native arteriovenous fistula (AVF) creation in end-stage renal disease (ESRD) patients, is destroyed frequently after its use as the entry site of PICC. The most well-established risk factors for CVD are a history of central venous catheter (CVC) insertion and its duration of use. Therefore, to reduce the incidence of CVD, catheterization in the central vein (CV) should be minimized, along with its duration of use. In this review, we will first explain the basic territories of the CV and introduce its pathophysiology, clinical features, and advanced treatment options. Finally, we will emphasize prevention of CVD.
Keywords: Central venous disease, Chronic kidney disease, Hemodialysis, Prevention


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