Dr
Saad is a physician at our hospital, and he is a Nephrologist. Any patient
that has a creatinine of 1.9 or greater is closely reviewed before placing a
PICC. If a line is needed and there is no potential for dialysis in the next
year we will place a PICC (elevated creatinine is not directly related to kidney
failure). If the patient is having any kidney failure VIR places a tunneled line
in the jugular. I was recently reading some information from the NKF and if I
remember correctly a normal creatinine should be 1.2 for women and 1.4 for men.
It is also stated that GFR is a better indicator than creatinine when
determining kidney failure. This needs to be calculated for every patient and
there is a link that helps with the calculation on their web site. I also have
two articles written by Dr. Saad. I have a great deal of respect for him and his
quest to keep peripheral veins from being damaged by any peripherally inserted
device.
-----Original Message-----
From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On Behalf Of Lynn Hadaway
Sent: Wednesday, September 20, 2006 11:16 AM
To: Erickson, Wendy; [EMAIL PROTECTED]
Subject: Re: Potential Dialysis Patients and PICCsThis comes directly from the Dialysis Outcome Quality Initiative (DOQI guidelines) from the National Kidney Foundation - www.nkf.org I think. LynnAt 6:51 AM -0500 9/20/06, Erickson, Wendy wrote:Last week at the AVA conference we heard a speaker indicate that a contraindication for a PICC is a patient with a creatinine greater than 3. Our docs have asked us to avoid the non-dominant arm for PICCs - which sometimes requires a crystal ball, as to who might end up on dialysis. Having something more concrete like the creatinine level would be much better for us. Is there any reference or study out there that backs this up? I know I will need ammunition when I approach the nephrologists and surgeons, beyond "I heard it at a conference"!Thanks in advance!Wendy Erickson RN
PICC Service Coordinator
Luther Midelfort - Mayo Health System
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