Peripheral central catheter insertion in low eGFR patients: Retrospective single institution study

Purpose: To identify the rate of Peripherally Inserted Central Catheter (PICC) placement in patients with chronic kidney disease (CKD), stage 3B or higher (glomerular filtration rate (eGFR) 45 mL/min/1.73 m2 (632/1985, 31.8%) (p-value < 0.0001, odds ratio 2.84 (95% confidence interval 2.38–3.38)). The rate of dialysis initiated in the year post PICC insertion was 5.9% (98/1657). This was significantly higher in patients with a low eGFR and not previously dialyzed (59/310, 19%) compared to patients with eGFR>45 who required dialysis in the year post insertion (39/1347, 2.9%) (p < 0.0001, odds ratio 7.88 (95% confidence interval 5.14–12.07)). Conclusion: PICC insertion in patients with CKD is practiced frequently. Rigorous strategies should be implemented to improve adherence to clinical practice guidelines and reduce unnecessary insertions and preserve veins for when an AVF may be required.