Superior vena cava syndrome: anaesthesia for renal access

Abstract

The incidence of end-stage renal disease (ESRD) is increasing exponentially, in parallel with the prevalence of diabetes, hypertension and obesity. The inevitable consequence is a dramatic increase in demand for dialysis and transplantation. Patients requiring urgent renal dialysis access are among the most sick who present for anaesthesia. When superior vena cava syndrome (SVCS) is superimposed, further anaesthetic challenges arise.