Subclavian vein catheterization in an infant with CRF: its clinical usefulness for prolonged HD

Abstract

PD or CAPD can be the first choice of treatment for infants with CRF and weighing less than 10kg because the construction and maintenance of the blood access are very difficult in such cases.
We reported a five month-old boy with CRF due to congenital hypoplastic kidney. He was admitted to our hospital with failure to thrive and tetany. Soon after admission he was introduced to PD and thereafter to CAPD. At 10 months of age, he was treated with HD using Brescia-Cimino's fistula becase of incurable peritonitis and the infection of Tenkoff's catheter outlet. At the age of one year, single needle maintenance HD with the a double pump via subclavian vein catheterization was started for the purpose of preserving blood vessels and waiting for the maturation of the internal A-V fistula. The subclavian vein catheter was exchanged at intervals of six to eight weeks without any troublesome infections. One year and one month after the maintenance of HD, transplantation with his mother's left kidney was performed successfully.
These results indicate that the subclavian vein cannulation for vascular access in infants with GRF is a clinically useful procedure not only in emergency HD, but also in prolonged HD.