PICC line contraindications

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I'm just wondering why one of the contraindications for PICC line insertion is renal failure? Lots of ESRD patients have access devices... so I'm confused why a PICC line is contraindicated? Please excuse my ignorance. I'm a new nurse, just wanting to learn.

Thanks!

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Specializes in Nephrology, Cardiology, ER, ICU.

Thats a good question. I'm in nephrology and work with ESRD pts. Heres the reasons:

1. Hemodialysis pts already have one arm tied up with a dialysis access (no BP, no sticks in that arm)

2. We don't want the other arm tied up with a PICC line.

3. Its just another source of infection and ESRD pts are already immunocompromised.

4. And please remind doctors of this too.

Recently had a pt in the hospital - had a dialysis fistula in one arm, the doc at the hospital had a PICC line placed for antibiotics in the other arm. The pt was a bilateral AKA. Uh - how do we obtain BPs?

So, moral of the story, ask why the PICC line is needed. If its for antibiotics, find out which ones are available at the dialysis unit and try to change over to that. (Many antibiiotics that are not readily available at the dialysis units can be ordered and available within 72 hrs)

Thanks for asking this excellent question and thanks for caring.

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Thats a good question. I'm in nephrology and work with ESRD pts. Heres the reasons:

1. Hemodialysis pts already have one arm tied up with a dialysis access (no BP, no sticks in that arm)

2. We don't want the other arm tied up with a PICC line.

3. Its just another source of infection and ESRD pts are already immunocompromised.

4. And please remind doctors of this too.

Recently had a pt in the hospital - had a dialysis fistula in one arm, the doc at the hospital had a PICC line placed for antibiotics in the other arm. The pt was a bilateral AKA. Uh - how do we obtain BPs?

So, moral of the story, ask why the PICC line is needed. If its for antibiotics, find out which ones are available at the dialysis unit and try to change over to that. (Many antibiiotics that are not readily available at the dialysis units can be ordered and available within 72 hrs)

Thanks for asking this excellent question and thanks for caring.

Learned something new today! Thank you!

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Specializes in Reproductive & Public Health.

traumaRUs, great response! I love seeing experienced nurses offer guidance to those who are just starting out.

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Specializes in SICU.

Good list. Also, in cases where an ESRD patient needs long term abx, consider a med port :)

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In the cases of many patients on our unit, nephrologists don't want to ruin a potential back-up site if their primary access is destroyed for one reason or another. Placement of PICC lines can ruin a perfectly fine potential fistula site. This is also true for your advanced CKD patients that are not on dialysis yet. So the first thing that should pop in your head, (and one the PICC nurse is going to ask you).... Is this patient a RENAL patient? What is his/her creatinine? Has this line been ok'ed by a nephrologist?

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Learned something new today! Thank you!

I second this! Thanks for the helpful explanation! :)

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Hi, I'm a Nurse Practitioner in cardiac, thoracic and vascular surgery. Another reason a PICC is contraindicated in a renal patient is you don't want to damage any veins that may be needed for future dialysis access grafts or fistulas.

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