Dialysis Performance of Single Lumen Subclavian Hemodialysis: A Comparative Study with Single Lumen Fistula Hemodialysis

Study of hemodialysis performance and recirculation ratios of subclavian catheter hemodialysis is reported. Data are compared to the results obtained when a conventional intrafistular single-lumen hemodialysis needle is used under similar conditions. Renal blood flow values were slightly but not significantly lower for subclavian hemodialysis. Small molecular extraction ratios were identical. Small molecular clearances were somewhat lower for the subclavian approach, especially at high dialyzer blood flow rates. However, the differences were not significant, and overall extraction ratios, calculated for the entire dialysis period with both access methods in 43 patients, were identical. Recirculation averaged 12.5% for the fistular approach and 20% for the subclavian approach. It is concluded that, as a whole, dialysis performance is somewhat lower with the subclavian vascular access method. This is mainly due to a higher recirculation rate, and in turn to the consequence of the length of the intravascular device. However, this minor differences do not necessitate changes in dialysis schedules.