الفهرس 
Review of LiteratureOnly 14 pages are availabe for public view
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Abstract
Chronic kidney disease (CKD) is one of the most prevalent public health problems in Egypt and the world with a lot of incident cases every year with high economic burden.
Although renal transplantation and hemodialysis through arteriovenous fistula remain as the main renal replacement therapy, a bridging therapy is needed in many patients before the start of these modalities.
Tunneled hemodialysis access device insertion in the jugular vein serves as this bridging therapy but doesn’t lack its well-known complications such as thrombosis, dislodgement and infection.
Two independent factors related to the catheter positioning; the catheter tip position and the tunnel length, were wanted to be studied as regard their relation to the development of complications.
This study included 65 CKD patients with de novo tunneled jugular venous access creation between September 2021 & August 2023 at interventional radiology unit of Ain Shams university hospitals and then we followed them up for catheter functionality and detected the complications related to catheter insertion.
The catheter related infection was correlated with catheter tip position as measured from the cardiomediastinal border. There was no other significant correlation between the independent factors and the other complications in this study. Thrombosis was correlated to dislodgement and early catheter removal.
Conclusion
In conclusion, the tunneled jugular venous access is considered in many times as an effective bridge therapy and very essential for CKD patients in the initial period of diagnosis before other more reliable interventions like renal transplantation and arteriovenous fistula creation and if these interventions temporarily become suboptimal. Although it can be performed with good technical success, it is not free from complications like thrombosis, dislodgement or infection with most of them occurred in the first three months. Close follow up of the catheter and adherence to relevant instructions are highly recommended for early detection and management of these complications.