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Recurrence of complications related to usual vascular access leads to exhausted vasculature. Several options were described in similar cases like tans-lumbar catheter and intra-atrial tunneled dialysis catheter. We report the case of a 22-year-old- male, with kidney failure, anuria and exhausted vasculature. Emergent kidney transplantation was not suitable to his case. We decided to combine peritoneal dialysis with once-a-week hemodialysis using a tans-lumbar tunneled catheter at first time,doi:10.31579/2639-4162/053 fatcat:byqo4ajzdfafpcsgr6pqq4ig7e