Emergency Hemodialysis through Arterial Accesses: A Potential Controversy

Here is a personal experience that I would appreciate if shared by other colleague nephrologists. What would any colleague do when faced with an ESRD patient with no feasible vascular or peritoneal access? Over the last eight years of working as a consultant nephrologist at Tabuk, Saudi Arabia, I have faced five dialysis patients with no available vascular or peritoneal accesses. On these occasions, I resorted to arterial hemo­dialysis with dialysis lines inserted generally through femoral arteries. On one occasion, (for one single dialysis session) a carotid artery was cannulated for the purpose of hemodialysis. Informed consents were obtained from all patients prior to arterial dialysis line insertion. Stress on possible development of leg/central nervous system infarction was stressed. The lines utilized were the regular dual lumen hemodialysis catheters.