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Chronic kidney disease (CKD) is a global health problem and is often associated with an increased risk of cardiovascular disease.

Cardiovascular disease is the leading cause of morbidity and premature mortality in people with chronic kidney disease. Also, patients with renal insufficiency have been found to be at higher risk of complications. The presence of cardiovascular disease can be a risk factor for CKD. The connection between them also contributes to their pathogenesis and progression in patients with any of the specific health problems. This risk often increases with the progression of CKD and is evidenced by a deterioration in urinary function, usually manifesting as a decrease in glomerular filtration rate and an increase in proteinuria.

Hypertension, one of the leading causes of renal failure, is a major culprit in this process, causing left ventricular hypertrophy, dilatation of the heart chamber and increased stress, ischemia, heart failure and arrhythmias. In addition to impaired coronary micro circulation, hypertension may contribute to the development of atherosclerotic coronary artery disease, especially in the presence of many lipid abnormalities observed in end-stage renal disease.

Some of the causes of cardiovascular disease are:

  • High blood pressure – high blood pressure (hypertension) is one of the most important risk factors for CVD.
  • Smoking.
  • High cholesterol.
  • Diabetes.
  • Overweight or obese.
  • Family history of CVD.


Patients with end-stage renal disease (CRF) treated with hemodialysis (HD) are increasing annually worldwide. Their quality of life to a large extent depends on the quality of their hemodialysis treatment. One of the main factors for this is the type of the used vessel access.

In practice, three main types of vascular access are used – arterio-venous fistula, arterio-venous prosthesis and central venous catheter – which in turn is divided into temporary and tunneled.

Temporary hemodialysis catheters were introduced in the mid-1970s, while tunneled catheters entered relatively later. Temporary vascular access is a consequence of emergencies through catheterization of large venous vessels. It is applicable in acute renal failure and is undesirable for chroniodialysis. Temporary catheters should be replaced by Permanent Tunneled Catheters.

The implantation of permanent tunneled catheters is performed by highly specialized physicians under constant ultrasound, X-ray or angiographic control during or after the procedure. They are most often implanted in the right atrium and are a complex medical procedure.

Permanent tunneled catheters are recommended in adult patients, such as those with cardiovascular disease, diabetics, cancer patients or in cases where prolonged stay of hemodialysis treatment is not expected.