infection, and kinking. One of the most common errors of tunnel hemodialysis catheter insertions is failure to locate the arterial limb of the catheter medially and the venous limb laterally. This must be done, because most catheters have a memory in the plastic, which will cause the catheter to try to resume its natural straight form. If the arterial limb is placed laterally, this will cause the arterial inlet to float up against the vein wall, or even up against the rim of the inlet of the atrium. This has the same effect as a vacuum cleaner hose sucking up against curtains. This results in poor blood flows, and can force the dialysis staff to reverse flow, using the venous limb of the catheter as the arterial. This will result in more inefficient dialysis, as there will be admixing of blood from the catheter (cleaning the same blood, over again). A dialysis catheter must have infusion of 30cc or greater to keep the line open. Intravenous fluids at 30ml per hour should be hung if being used for infusion. Fistulas versus catheters Surgically created arteriovenous fistulae are preferred over catheters for patients with chronic kidney failure, as the risk of infections (e.g., endocarditis, bacteremia), hospitalization and death are lower. References External links Catheter Catheters