Use of permanent dual lumen catheters for long-term haemodialysis.

Permanent dual lumen catheters (PDLC) provide alternative vascular access in patients considered unsuitable for arteriovenous fistula, arteriovenous graft or peritoneal dialysis. Experience with their use for long-term haemodialysis is presented. Between January 1990 and April 1994, 101 catheters were inserted into 63 patients (median age 62 years). A PDLC was the primary vascular access type in 5 patients. Of the first catheters, 70% were inserted percutaneously into the subclavian vein. The median duration of catheter use was 168 days (range 5-1582 days). The overall cumulative observed catheter survival rate was 94% at 6 months, 89% at 1 year and 75% at 4 years following insertion. The major complications were blockage and catheter related infection occurring in 28% and 15% of catheters, respectively. Death and blockage were the commonest reasons for catheter removal. PDLC play a vital role in the provision of access for long-term dialysis and should be considered the access type of choice in patients with limited life expectancy.