Kidney Dialysis Catheter Placement

By implanting a catheter for dialysis access, you will be able to receive regular hemodialysis treatments. During your treatments, your health care provider will connect tubes from the dialysis machine to the portion of the catheter that is outside of your body. This will allow for blood to easily be removed and replaced.

When you arrive for your procedure a nurse will greet you and let the team know you’ve arrived. You will be brought into an exam room and asked to change into a gown. Your doctor will greet you, explain the procedure and answer any questions you may have.

You will lie on an exam table for the procedure. The technologist or nurse will connect monitors for your heart rate, blood pressure, and pulse, and an intravenous (IV) line will be inserted into a vein in your hand or arm. This will be used to give you sedatives during the procedure. Some patients receive general anesthesia, but in most cases, this is not necessary.

The technologist will shave, sterilize, and cover the area of your body where a catheter will be inserted with a surgical drape. The area will then be numbed using a local anesthetic. You may feel a tiny pinch when the anesthesia is administered. The radiologist will make a very small nick, and you may feel some pressure as the catheter is inserted, but you won’t feel any serious discomfort. Using image-guidance, the catheter will be manipulated to the vein. You may feel some additional pressure as the catheter is put in place. The procedure usually takes between 30 and 40 minutes.

Some patients stay overnight but in most cases this is not necessary. You will need to rest after the procedure and should avoid strenuous activity for several days. Your doctor will instruct you on any specific limitations to your daily activity.

You may have some swelling or bruising at the sight of the catheter. In most cases over-the-counter pain medications can help with this. You should talk to your physician if you experience any discomfort after the procedure.

Your doctor will give you specific instructions about caring for the catheter. The most important thing to keep in mind is that the site must be kept clean and dry. You will not be able to shower for about a week after the procedure. After a week you can shower but you will be required to cover the catheter with plastic to keep it dry. Your doctor may suggest cleaning the area with antibacterial cleaners, such as peroxide, and applying antibiotic cream to the area.

In addition, your doctor may give you instructions about cleaning the catheter with solution to keep any clots from forming and causing blockages.

You should call your doctor if you have any problems with the catheter or if you have any bleeding, fever, increased swelling or drainage at the catheter insertion site.

There are things you can do to make your experience more comfortable, and many of these will depend on your individual preferences. For example, you may want to arrange to have someone drop you off and pick you up. You might like to keep a list of questions or — as you’re doing now — educate yourself about the procedure.

Some other things to keep in mind in planning for this procedure include:

• Wear loose, comfortable clothing to the procedure.
• Your doctor may ask you to stop taking aspirin, non-steroidal anti-inflammatory drugs (NSAIDS), or blood thinners (such as Coumadin or warfarin) for a time before the procedure.
• The day before the procedure (or the Friday before, if you’re scheduled for a Monday procedure), a nurse from your doctor’s office will call you. The nurse will give you any additional instructions, and will ask if you have any questions.
• When you arrive, make sure the nurse and radiologist know about any allergies you may have, especially allergies to local anesthetics, such as lidocaine. If there’s any chance you may be pregnant, tell your physician

On the day of your procedure you should:

• Wear comfortable, loose-fitting clothes
• Wear comfortable shoes
• Avoid bringing jewelry or valuables

Risks you should be aware of include:

• As with any procedure, there is a small risk of infection. The chance of infection requiring antibiotic treatment is less than one in 1,000.
• Potential for damage to the blood vessel, bruising or bleeding at the puncture site

Keep in mind that this information is general. Your radiologist is the best source of information about how these risks and benefits may apply to you.