Would you replace a temporary dialysis catheter with a tunneled dialysis catheter in an ESKD patient with an immature fistula that is expected to mature in 2-4 weeks?

Yes, 2-4 weeks is too long to keep a temp line. High infection risk at that point. (Assuming this patient is an inpatient as well, as a temporary line is not acceptable in an outpatient setting.)

Most likely, yes.

The need for a tunneled dialysis catheter after fistula creation depends on how much residual kidney function remains and how well the patient’s symptoms can be medically controlled. When residual function is poor, the patient generally cannot maintain adequate clearance or volume without ongoing dialysis, so a tunneled catheter becomes the practical bridge while the fistula matures and allows outpatient dialysis to continue.

Arteriovenous fistulas vary widely in how quickly and how well they mature: it may take longer than 4 weeks to reach adequate size and flow; they may need additional procedures - angioplasty of stenoses or ligation of side branches before they can be used consistently.

Ultrasound‑guided cannulation ca...