Subclavian vein catheterisation for haemodialysis.

Immediate access to the circulation for haemodialysis may be necessary in patients with acute renal failure or when end stage renal disease presents acutely. Vascular access may be required in patients treated by continuous ambulatory peritoneal dialysis if that technique is interrupted or, following failure of an arteriovenous fistula in patients on maintenance haemodialysis. Haemodialysis via a catheter in the subclavian vein meets these needs. Our experience with 67 patients over two years confirmed the safety and reliability of this means of access. Benefits included easy, rapid catheter placement, full patient mobility, allowing outpatient dialysis where appropriate, and the sparing of peripheral vessels for future access. With careful attention to technique by experienced personnel complications are largely preventable.