The Issues Related to Hemodialysis Catheter Lock Prophylaxis with Recombinant Tissue Plasminogen Activator

Arteriovenous fistulas (AVF) are the most preferred and promoted form of dialysis access due to their lowest complication rates. However, the changing demographic profile of endstage renal disease (ESRD) with an increasing elderly and diabetic population having relatively poor vasculature, relative lack of prudent pre-ESRD planning for AV fistula creation, late referrals, and comparatively lower fistula maturation rates, are essentially the factors accountable for our continued dependence upon central venous catheters (CVCs) [1-3]. Moreover, CVCs remain the only means to provide instant access to the circulation during emergency situations arising from the unpredictable course of chronic kidney disease.