PICC line management among patients with chronic kidney disease

• Published in: The journal of vascular access Vol. 24; no. 2; p. 329
• Main Authors: Oza-Gajera, Bharvi P, Davis, James A, Farrington, Crystal, Lerma, Edgar V, Moossavi, Shahriar, Sheta, Mohamed A, Dwyer, Amy, Almehmi, Ammar
• Format: Journal Article
• Language: English
• Published: United States 01.03.2023
• Subjects: Catheter-Related Infections - diagnosis; Catheter-Related Infections - prevention & control; Catheterization, Central Venous - adverse effects; Catheterization, Peripheral - adverse effects; Central Venous Catheters - adverse effects; Humans; Kidney Failure, Chronic - complications; Kidney Failure, Chronic - diagnosis; Kidney Failure, Chronic - therapy; Parenteral Nutrition - adverse effects; Renal Insufficiency, Chronic - complications; Renal Insufficiency, Chronic - diagnosis; Renal Insufficiency, Chronic - therapy; Retrospective Studies; Venous Thrombosis - etiology; dialysis access; peripherally inserted central catheters; ESKD; Chronic kidney disease; catheters; vascular access; PICC line
• ISSN: 1724-6032
• DOI: 10.1177/11297298211025897

More than 1 million peripherally inserted central catheters (PICC) are placed annually in the US and are used to provide convenient vascular access for a variety of reasons including long term antibiotic treatment, chemotherapy, parenteral nutrition, and blood draws. Although they are relatively easy to place and inexpensive, PICC line use is associated with many complications such as phlebitis/thrombophlebitis, venous thrombosis, catheter-related infection, wound infection, and central vein stenosis. These complications are far more deleterious for patients with chronic kidney disease (CKD) whose lives depend on a functioning hemodialysis access once they reach end stage kidney disease (ESKD). Despite recent guidelines to avoid PICC lines in CKD and ESKD patients, clinical use remains high. There is an ongoing urgency to educate and inform health care providers and the CKD patients themselves in preserving their venous real estate. In this article, we review AV access and PICC line background, complications associated with PICC lines in the CKD population, and recommendations for alternatives to placing a PICC line in this vulnerable patient population.