Thread by @SaiAchi1

Permacath, Hickman, Vascath, Shiley?

Is your nephrology rotation coming up? Catheters giving you nightmares?

Here’s a #tweetorial on types of dialysis catheters!#dialysiscatheters #MedED #medtwitter #nephtwitter

POLL
What types of catheters can be used for dialysis?

Before we get to the correct answer. Let’s break it down.

Dialysis catheters are conduits that are used to gain access to the intraperitoneal or intravascular space for renal replacement.

Broadly, dialysis catheters can be broken down into those used for extracorporeal dialysis and those for peritoneal dialysis. More about peritoneal in a bit…

Extracorporeal Dialysis includes:
✨hemodialysis
✨ultrafiltration
✨ hemodiafiltration
✨ continuous renal replacement therapy (CRRT)

Further information on these modalities are summarized below:
pubmed.ncbi.nlm.nih.gov/17912223/

You can have either tunneled or non tunneled catheters.

Tunneled catheters:
✨ are called tunneled because they are placed under the skin
✨are used for longer termed dialysis catheters
✨are used when AV fistulas are maturing

lavascular.com/permcath/

Nontunneled:
🌪are used for shorter duration
🌪are used for more emergent situations

The differences are highlighted here:

Where can these catheters be placed?

This schematic highlights locations of placement.

Just remember for non tunneled: AVOID the subclavian if possible

mdpi.com/coatings/coati…

Now that we have a grip on extracorporeal...it's time for Peritoneal Dialysis Catheters!!

Peritoneal dialysis catheters are placed in the intraperitoneal space and used for peritoneal dialysis

PD uses the peritoneal space for exchange.

niddk.nih.gov/health-informa….

P.D. catheters come in different types and shapes... some of which are highlighted in the post by @tulunsokit :

renalfellow.org/2020/07/31/ten…

heraldopenaccess.us/openaccess/doe…

This table is a quick reference about peritoneal dialysis catheters and considerations:

Is it all roses and rainbows with catheters?

Are there any complications with PD and extracorporeal catheters?

The schematic below highlights some potential complications of catheters.

ncbi.nlm.nih.gov/pmc/articles/P…

So back to our question in the beginning…

All of these types of catheters can be used. It just depends on the situation.

Now we have a basic idea of the types of catheters that patients can have!

Go and show off your skills and learn even more on your next nephrology rotation!

For more information, check out the post on dialysis catheters 101 on RFN:

renalfellow.org/2021/05/29/dia…

Thank you @NSMCInternship and the amazing #BeanPod! @NSMCInternship @hellokidneyMD @nephromythri @lama_ghazi @brian_rifkin @SRameshMD @jadav_md @elliotktannor @dr_missyhanna
#medtwitter #NephTwitter @AJKDonline @RenalFellowNtwk

Special Thanks to the Faculty! @sophia_kidney @drM_sudha @SwastiThinks @docanjuyadav @Nephro_Sparks @amyaimei @edgarvlermamd @Tiff_Caza @captainchloride @AnnaGaddy @DrFlashHeart @ghobby