| [ Summary ] |
The guideline committee of the Japanese Society for Dialysis Therapy (JSDT), chaired by Dr. Kukita, published the 2nd edition of the "Japanese Society for Dialysis Therapy Guidelines for Vascular Access Construction and Repair for Chronic Hemodialysis" in 2011. In these guidelines, the cuffed catheter is used for (i) patients for whom AVF or AVG cannot be constructed or repaired; (ii) patients with severe heart failure (iii) patients at high risk during dialysis treatment, such as difficult puncture cases or patients with contracture of the extremities; and (iv) those requiring VA for pediatric hemodialysis.
An important role of this method can be played in cases of diabetic nephropathy, renal sclerosis, or for long-term dialysis patients. This method should be used more frequently for heart failure patients, and might be used for home dialysis patients in the near future, after proper trials and discussions. For the above purposes, however, more stable and better long term performance from catheters is essential. Reliable safety measures to guard against infection are urgently needed for use in target patients with very limited immune functions. Innovative improvements in the shape and materials catheter are made of are vitally important. |