Medical Condition Library

Information Centers

Wellness Centers

Helpful Resources

Tunneled Dialysis Catheter Placement

by Cynthia M. Johnson, MA

Home | Health Information Center | Procedure & Surgery Fact Sheets | Article

Definition

Reasons for Procedure

Call Your Doctor

En Español

Definition

Tunneled dialysis catheter placement inserts a tube (catheter) under the skin and into a major vein.

The tube has two openings. The blood leaves the body through the red opening. It is filtered and cleaned through dialysis. The cleaned blood returns through the blue opening.

Reasons for Procedure

This procedure is done to allow quick access to blood flow to do dialysis. Dialysis is a process that filters and cleans the blood when the kidneys can no longer do this on their own.

People who have this catheter do not need to have multiple needlesticks at every dialysis visit. This lowers the risk of infection and damage.

Dialysis

Possible Complications

Problems are rare, but all procedures have some risk. The doctor will go over some problems that could happen, such as:

Excess bleeding
Problems from anesthesia or contrast material, such as wheezing or sore throat
Infection
Blood clots
Scarring and narrowing of the vein—venous stenosis
Irregular heart rhythm
A collapsed lung
Injury to blood vessels or the heart

Things that may raise the risk of problems are:

Smoking
Alcohol use disorder (AUD)
Chronic diseases, such as diabetes or obesity

What to Expect

Prior to Procedure

The surgical team may meet with you to talk about:

Anesthesia options
Any allergies you may have
Current medicines, herbs, and supplements that you take and whether you need to stop taking them before surgery
Fasting before surgery, such as avoiding food or drink after midnight the night before
Whether you need a ride to and from surgery
Tests that will need to be done before surgery, such as images of the kidneys

Anesthesia

The doctor may give:

A sedative—you will feel relaxed
Local anesthesia—the area will be numbed

Description of the Procedure

An ultrasound and x-rays using contrast material will be used to help locate the vein. It will also help put the catheters in place.

A small incision will be made in the lower neck. The doctor will access the jugular vein in the neck with a needle and pass a small guidewire into the vein. The guidewire will be passed to a larger blood vessel called the vena cava.

A second incision will be made in the chest below the first incision. A tunnel will be made just under the skin between the first and second incisions. The flexible dialysis catheter is then passed from the second incision, through the tunnel, to the first incision site. This is where it is passed over the guidewire and into its final position. The guidewire is removed from the blood vessels. The other end of the catheter will remain outside of the body, extending through the second incision. The doctor will make sure that blood is flowing in the catheter.

Correct catheter placement can be checked with x-rays. The catheter will be secured with stitches. Some catheters have a cuff that sits in the tunnel under the skin. This cuff helps keep the tube secure and free of infection. The first incision will be closed. It may be closed with stitches, tape, or a type of medical glue. The second incision will be stitched around the catheter to help it stay in place. Both areas will be bandaged.

How Long Will It Take?

Less than 1 hour

Will It Hurt?

Pain is common in the first few days. Medicine and home care can help.

Post-procedure Care

At the Care Center

The staff may give you medicine to ease pain.

During your stay, staff will take steps to lower your chance of infection, such as:

Washing their hands
Wearing gloves or masks
Keeping your incisions covered

You can also lower your chance of infection by:

Washing your hands often and reminding visitors and staff to do the same
Reminding staff to wear gloves or masks
Not letting others touch your incisions

At Home

Recovery can take 2 to 4 weeks. You may need to ask for help with daily activities. Some physical activities may need to be limited during this time.

Call Your Doctor

Call the doctor if you are not getting better or you have:

Signs of infection, such as fever or chills
Increased redness, pain, swelling, or discharge at the insertion sites
Swelling or pain in either arm
A catheter that gets wet
Accidently kinked one or both catheters for more than a minute
A catheter that moves or falls out
Changes in heart rhythm

If you think you have an emergency, call for medical help right away.

RESOURCES:

National Institute of Diabetes and Digestive and Kidney Disorders
http://www.niddk.nih.gov

National Kidney Foundation
https://www.kidney.org

CANADIAN RESOURCES:

Health Canada
https://www.canada.ca

The Kidney Foundation of Canada
https://www.kidney.ca

References:

Hemodialysis. National Institute of Diabetes and Digestive and Kidney Disorders website. Available at: https://www.niddk.nih.gov/health-information/kidney-disease/kidney-failure/hemodialysis. Accessed September 16, 2020.

Hemodialysis catheters: How to keep yours working well. National Kidney Foundation website. Available at: https://www.kidney.org/atoz/content/hemocatheter. Accessed September 16, 2020.

Vascular access procedures. Radiological Society of North America Radiology Info website. Available at:
...(Click grey area to select URL)
Accessed September 16, 2020.

Last reviewed March 2020 by EBSCO Medical Review Board Shawna Grubb, RN
Last Updated: 3/24/2021

EBSCO Information Services is fully accredited by URAC. URAC is an independent, nonprofit health care accrediting organization dedicated to promoting health care quality through accreditation, certification and commendation.

This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.

To send comments or feedback to our Editorial Team regarding the content please email us at healthlibrarysupport@ebsco.com. Our Health Library Support team will respond to your email request within 2 business days.