Predictors of Central Venous Catheter Use at the Initiation of Hemodialysis

Central venous catheter (CVC) use at hemodialysis (HD) initiation remains high, despite reports of CVC‐associated morbidity and mortality, and efforts at early arteriovenous fistula placement. In order to determine predictors of CVC use at the start of HD, data from the end‐stage renal disease (ESRD) Clinical Performance Measures (CPM) Project was linked to the Centers for Medicare & Medicaid Services Medical Evidence (2728) Form. Of the 4071 incident hemodialysis patients in study years 1999–2003, 71.6% used a CVC at dialysis initiation. After controlling for demographic and co‐morbid variables, patients with a CVC were 24% more likely to be female (p = 0.006), and 38% more likely to have ischemic heart disease (p = 0.002), while those with obesity (BMI ≥30) were 24% less likely to start dialysis with a CVC (p = 0.006). Pre‐ESRD hypoalbuminemia (