Perm Catheter

Chronic Kidney Disease (CKD) is increasing globally and in Kerala. Despite appropriate treatment, CKD progresses. When Creatinine is above 5 mgs or Blood urea above 120 mgs you may have to consider need Renal Replacement Therapy as dialysis or kidney transplantation. For doing dialysis you need an access - means taking out blood from the body and returning it after passing through the dialysis machine after filtration. Arterio Venus Fistula (AVF) is the best access and is to be done early when the creatinine is @ 4 mgs to 5 % mgs. Many people are undecided, have difficulty in getting AVF done at an early stage. For those who don't have a successful matured AVF, then Double Lumen Jugular Catheter (DLJC) is the next option.

There are two types of DLJC Catheters . A temporary catheter , which may lasts for couple of weeks to couple of months and may cost @ Rs. 7000/- . The second one is a tunneled jugular catheter like what is shown (the picture above) which may cost @ 25000/- - Rs. 30000/-. The advantages of a catheter is that dialysis can be initiated at the earliest and without delay in contrast to AVF which will take weeks to mature. The advantages of Tunneled catheter over temporary catheter are:

Long Lasting/li>
Blood Flow better
Less infection, catheter doesn't move
This Catheter will be covered by the shirt or the top and therefore it is more appealing.

You can work with this catheter in situ and continue dialysis as needed. Tunneled catheter has to be put electively by trained people because bleeding tendency is more when patient is breathless or with high urea and creatinine. Tunneled catheter also can produce infection, though less and is treatable. If not responding to treatment, catheter will have to be removed. Clotting can be prevented by anti clotting medications.

Therefore to have a good access for dialysis, plan AVF at the earliest and give maturation time of 6 - 8 weeks. If you don't have an AVF, then opt for a tunneled double lumen catheter . Bottom line is the ordinary Double Lumen Jugular cathere. Plan Accordingly.

All the best