Park Hoon Suk, Choi Joonsung, Baik Jun Hyun
Division of Nephrology, Department of Internal Medicine, Eunpyeong St. Mary's Hospital, School of Medicine, The Catholic University of Korea, Seoul, Korea.
Department of Radiology, St. Vincent's Hospital, School of Medicine, The Catholic University of Korea, Suwon, Korea.
Kidney Res Clin Pract. 2019 Sep 30;38(3):309-317. doi: 10.23876/j.krcp.19.025.
Central venous disease (CVD) is difficult to treat and often resistant to treatment. In CVD, hemodialysis vascular access should sometimes be abandoned, or in serious cases, the patient's life may be threatened. Therefore, prevention is ideal. However, as the prevalence of chronic kidney disease (CKD) has increased steadily with population aging, CKD patients with a peripherally inserted central catheter (PICC) are encountered frequently. PICCs can cause CVD, and the basilic vein, which is regarded as the important last option for native arteriovenous fistula (AVF) creation in end-stage renal disease (ESRD) patients, is destroyed frequently after its use as the entry site of PICC. The most well-established risk factors for CVD are a history of central venous catheter (CVC) insertion and its duration of use. Therefore, to reduce the incidence of CVD, catheterization in the central vein (CV) should be minimized, along with its duration of use. In this review, we will first explain the basic territories of the CV and introduce its pathophysiology, clinical features, and advanced treatment options. Finally, we will emphasize prevention of CVD.
中心静脉疾病（CVD）难以治疗且常常对治疗有抵抗性。在CVD中，血液透析血管通路有时不得不被舍弃，或者在严重情况下，患者的生命可能受到威胁。因此，预防是理想的措施。然而，随着慢性肾脏病（CKD）的患病率随着人口老龄化而稳步上升，外周静脉置入中心静脉导管（PICC）的CKD患者屡见不鲜。PICC可导致CVD，而在终末期肾病（ESRD）患者中被视为自体动静脉内瘘（AVF）建立的重要最终选择的贵要静脉，在用作PICC的穿刺部位后常遭破坏。CVD最明确的危险因素是中心静脉导管（CVC）置入史及其使用时长。因此，为降低CVD的发生率，应尽量减少中心静脉（CV）置管及其使用时长。在本综述中，我们将首先阐释CV的基本区域，并介绍其病理生理学、临床特征及先进的治疗选择。最后，我们将着重强调CVD的预防。
