Patient education: How to care for a hemodialysis catheter (The Basics)

What is a hemodialysis catheter? — To have hemodialysis, you need a way for blood to leave and return to your body. This is called an "access." A hemodialysis catheter is 1 type of access. This type of catheter is also called a central venous catheter ("CVC"). It is a thin tube that goes into a large vein, usually in the neck (figure 1).

A hemodialysis catheter can go directly through the skin into the vein or might be "tunneled" under the skin. It will have 2 ends called "lumens" or "hubs." These stay outside of the body and are covered with caps when not in use. Most hemodialysis catheters have a clamp that closes off the lumens when not in use.

Hemodialysis catheters are often used in the hospital to give you dialysis. In some cases, though, people go home with a tunneled hemodialysis catheter. A tunneled catheter can stay in place for weeks or months.

How do I care for myself at home? — Ask the doctor or nurse what you should do when you go home. Make sure that you understand exactly what you need to do to care for yourself. Ask questions if there is anything you do not understand.

You might need a family member or friend to help you care for the hemodialysis catheter. Some people have a home health nurse come to their home to help with this.

Before you go home, your doctor or nurse will talk to you about the kind of hemodialysis catheter you have. They will show you how to care for it and make sure that you have the supplies you need. Having a hemodialysis catheter increases your risk of infection. This is why it's so important to take care of it.

How do I care for the catheter and dressing? — Keep the dressing over the dialysis catheter clean and dry. This can help prevent infection. The staff will change the dressing when you get dialysis.

●Wash your hands with soap and water before you touch the dialysis catheter or dressing.

●Keep the catheter clamped when not in use, if it has a clamp.

●Do not remove the caps from the end of the catheter.

●If the dressing starts to peel up around the edges, reinforce them with tape. If the dressing becomes very loose, wet, or soiled, call your dialysis nurse. You might need to go and have the dressing replaced.

●Do not get the dressing or catheter wet. In some cases, you are allowed to shower if the catheter and dressing are covered. In other cases, you might need to do sponge baths instead. Follow your doctor's instructions about whether it is OK to shower.

●Avoid swimming in ponds, lakes, rivers, oceans, pools, or hot tubs.

●Make sure that the catheter is secured with special holders or tape.

●Do not use lotion near the catheter dressing.

What else should I know? — While your hemodialysis catheter is in, you should:

●Avoid contact sports or rough play.

●Keep sharp objects away from the catheter.

●Do not to pull on or twist the catheter.

●Wear loose-fitting clothing around the catheter. Do not get it caught in zippers.

When should I call the doctor? — Call for advice if:

●You have symptoms of infection. These include a fever of 100.4°F (38°C) or higher, chills, and redness, drainage, warmth, stinging, or pain where the hemodialysis catheter goes into your skin.

●There are problems with the hemodialysis catheter, like:

•The catheter falls out all of the way or part of the way. If there is bleeding, apply pressure where the catheter goes into your skin.

•There are breaks, cracks, or leaks in the catheter.

•You have any concerns about the catheter.

●You have sudden shortness of breath or chest pain.

●You notice swelling on the face, neck, or chest on the side of the line, or swelling or bulging veins around where it enters your skin.

More on this topic

Patient education: Hemodialysis catheter placement (The Basics)
Patient education: Preparing for hemodialysis (The Basics)
Patient education: Hemodialysis (The Basics)
Patient education: Arteriovenous vascular access for hemodialysis (The Basics)

Patient education: Hemodialysis (Beyond the Basics)