TRANSHEPATIC PERMCATH FOR HEMODIALYSIS

The establishment and maintenance of a reliable vascular access contin ues to be a problem in hemodialysis. We report a patient with end-stag e lupus nephritis who had no alternative for vascular access and faile d peritoneal dialysis. A vascular access device (PermCath, Quinton Ins trument Co, Bothell, WA) was inserted using a transhepatic approach. T here were no bleeding or thrombotic complications. The catheter was re placed once through the same track due to poor blood flow and reinsert ed once after 5 days due to infection. The patient has been doing well and receiving adequate dialytic therapy for over 1 year with this for m of vascular access. (C) 1994 by the National Kidney Foundation, Inc.