The use of permanent double lumen hemodialysis catheters (PermCath, Quinton, Seattle, WA) was surveyed in 17 dialysis units with a total of 1,372 patients. During the period of study, 210 patients received or already had such catheters. Their use varied widely, being highest in units dialyzing many older patients with associated diseases and difficulties with vascular access. Flow problems occurred in 46% and clotting in 24%; 27% required urokinase (at least once), and 10% received some form of anticoagulation. Local infections occurred in 15% and septicemia (at least once) in 15%. Some older patients elected to continue with this form of "painless" dialysis.