Education-Based Nursing Management of Vascular Access Complications in End-Stage Renal Disease: A Case Study
DOI:
https://doi.org/10.31436/ijcs.v9i1.514Keywords:
Nursing management, Haemodialysis, Catheter obstruction, End-stage renal disease, Case reportAbstract
Background: End-stage renal disease (ESRD) requires lifelong haemodialysis (HD) therapy. Functional vascular access is a key determinant of the success and adequacy of HD therapy and patient safety. Despites advance in vascular access management, catheter-related complications, such as luminal obstruction, continue to present significant challenges in clinical practice. This study aims to describe the education-based nursing management in addressing vascular access complications, particularly catheter obstruction in ESRD patient undergoing HD.
Case Presentation: Mrs. AN, a 58-year-old woman with ESRD experienced complete obstruction of both lumens of her right subclavian catheter during HD therapy. The procedure was interrupted for 2 hours and 25 minutes despite a 45-minute heparin flush without success. Previously, a similar incident occurred, which was a month earlier.
Conclusion: Nursing management of ESRD patients with catheter obstruction requires an integrated approach combining nursing education for patients and nurses with appropriate clinical interventions. This education encompasses vascular access care, early detection of obstruction, hygiene practices, and adherence to haemodialysis schedules. This case study highlights that effective nursing education has the potential to improve patients’ knowledge, skills, and adherence, thereby contributing to the prevention of recurrent complications, enhanced patient safety, and long-term therapeutic success.
References
Braun M, Khayat M. Kidney disease: end-stage renal disease. FP Essent. 2021;509:26–32. Available from: https://consensus.app/papers/kidney-disease-endstage-renal-disease-khayat-braun/ab65109b21205115af44a7b7798d1dff/
Besarab A, Frinak S, Margassery S, Wish J. Hemodialysis vascular access: a historical perspective on access promotion, barriers, and lessons for the future. Kidney Med. 2024;6:100871. Available from: https://consensus.app/papers/hemodialysis-vascular-access-a-historical-perspective-on-margassery-besarab/3621ace964da553a987d75ad49e99ebb/
Bagc? MS, Erdem AY, Ozbek NY, Yaral? N. Port-catheter complications in children with malignancy. Turk Arch Pediatr. 2025;60:99–104.
Franchin M, Tadiello M, Guzzetti L, Gattuso A, Mauri F, Cervarolo M, et al. Acute problems of hemodialysis access: thrombosis, aneurysms, symptomatic high-flow fistulas, and complications related to central lines. Semin Vasc Surg. 2023;36(2):300–6. Available from: https://consensus.app/papers/acute-problems-of-hemodialysis-access-thrombosis-franchin-tadiello/75e49129471d557cbbc4abb34666b39d/
Lazarus B, Kotwal S, Gallagher M, Gray N, Coggan S, Rogers K, et al. Effect of a multifaceted intervention on the incidence of hemodialysis catheter dysfunction in a national stepped-wedge cluster randomized trial. Kidney Int Rep. 2023;8:1941–50. Available from: https://consensus.app/papers/effect-of-a-multifaceted-intervention-on-the-incidence-of-gray-kotwal/ae002adbd1c45246baf61437d14f99fc/
Sun J, Fan H, Cui T. Management of tunneled-cuffed catheters in hemodialysis patients with hypotension and recurrent central venous thrombosis: a single-center retrospective cohort study. Sci Prog. 2025;108. Available from: https://consensus.app/papers/management-of-tunneledcuffed-catheters-in-hemodialysis-sun-fan/c954628f30b35ffab704b9bb6a49ef4d/
Fathy R, Monem A, Abdullah WH, Atallah HR. Effect of nursing intervention on controlling interdialytic weight and vascular access complications among patients undergoing hemodialysis. 2022;351–66.
Wembenyui C, Marsh N, Larsen E. Educational or behavioural interventions to improve long-term haemodialysis vascular access self-management: a systematic review. J Ren Care. 2024.
Wilson S, Mone P, Kansakar U, Jankauskas SS, Donkor K, Adebayo A, et al. Diabetes and restenosis. Cardiovasc Diabetol. 2022;21:1–14. doi:10.1186/s12933-022-01460-5
Li X, Weber NC, Cohn DM, Hollmann MW, Devries JH, Hermanides J, et al. Effects of hyperglycemia and diabetes mellitus on coagulation and hemostasis. Thromb Haemost. 2021;121:153–64.
Jalili J, Vaseghi S, Asvadi T, Baastani M. Evaluating tissue plasminogen activator (tPA) in dialysis catheter dysfunction: a focus on fibrin sheath and risk factors. Am Heart J Plus. 2025;58.
Hernán V, Muñoz GM, Monroy AM, Cabana AF, Rivas EO, García IZ, et al. Influence of care on the prevention of bacteremia in hemodialysis: systematic review. Nephrol Nurs J. 2023;50(4):333–44. Available from: https://consensus.app/papers/influence-of-care-on-the-prevention-of-bacteremia-in-hernán-cabana/9dc339ed7bdf55229bb5abd5c48499b4/
Almeida ACN, Pires MH, Santana IS, Salgado PO. Effectiveness of an educational intervention for the prevention of catheter-related infections in hemodialysis patients. 2022.
Ribeiro GDSR, Campos JF, Silva RC. What do we know about flushing for intravenous catheter maintenance in hospitalized adults? Rev Esc Enferm USP. 2022;75(5):1–11.
Smith K, Ayars C. Improving vascular access knowledge and assessment skill of hemodialysis staff. J Osteopath Med. 2025;125(6):321–7. doi:10.1515/jom-2023-0262
Villanueva AD. A systematic review of patient education strategies for arteriovenous fistula care in hemodialysis patients. 2024;2–5.
Pilard M, Ollivier EL, Gourdou-Latyszenok V, Couturaud F, Lemarié CA. Endothelial cell phenotype, a major determinant of venous remodeling. Front Cardiovasc Med. 2022;9:1–18.
Lourdes C, Evalaroza T, Bernadette S, Baleña L. Guarding the line: a systematic review of nurse-led infection prevention protocols for reducing catheter-related bloodstream infections in hemodialysis settings. 2025;7(4):1–34.
Mahmoud HM, Ahmed DA, Rady SE. Nurses’ knowledge and practices regarding permanent vascular access care among patients on hemodialysis. 2024;15(2):1470–89.
Khalid H, Sarwar H, Azam S. Effect of standardized educational intervention on nurses’ knowledge and practices regarding management of hemodialysis. 2025;3(7).
Wang J. Comprehensive nursing care for vascular access in hemodialysis patients with end-stage renal disease. Int J Public Health Med Res. 2024. Available from: https://consensus.app/papers/comprehensive-nursing-care-for-vascular-access-in-wang/3c1cee8a0f0759ff939a1db849eaa704/
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