Understanding your haemodialysis catheter (permacath)
What is a tunnelled haemodialysis catheter (permcath)?
A haemodialysis catheter is a flexible tube used for dialysis treatment. The catheter is placed into the blood vessel in your neck or upper chest and is threaded to the right side of the heart. The catheter has two tubes inside, one to take blood to the dialysis machine the other to return the blood to you.
The procedure involves creating a tunnel under the skin to thread the catheter. The catheter has a cuff under the skin to help keep the catheter in place, prevent infection and allow the catheter to remain in for an extended period of time.
Are there any alternatives to a catheter?
It is preferable to have a fistula created as they last longer and have fewer problems. A fistula requires 6 to 8 weeks after the operation for the vein to become wider and thick walled. If you have had a fistula created, you will still require your catheter during this time, until your fistula is usable.
Other important information
Do I need an anaesthetic?
No, you do not need a General Anaesthetic. Sedation medication may be given before the procedure.
What are some of the risks of the procedure?
Infection: See a doctor immediately in the hospital emergency department, if there are any signs of infection, such as; redness, discharge, pain, swelling, you feel unwell or have shivers and shakes. Infection can occur at the site where the catheter enters the skin or in the blood stream.
Bleeding: there is the possibility of bleeding from the site where the catheter enters the skin. If bleeding occurs at home, sit upright and apply a pressure with a clean cloth. This usually settles, but if bleeding is excessive or continues beyond 15 minutes, call an ambulance.
Puncture of lung wall: There is only a small chance this will occur. If you are short of breath or have pain in the chest after your catheter is inserted, tell the nurse or doctor.
Not enough blood flow in and out of the catheter: If the catheter is kinked, in the wrong position or a blood clot has formed at the end of the catheter, the catheter may need to be removed.
How long will I be in hospital?
This procedure is usually performed as a day case, meaning that you can go home the same day as the procedure. You will need to organise someone to pick you up and take you home after the procedure and you should have someone stay with you that night. If you live further than 1 hour drive away, you will need to organise somewhere to stay in or around Hobart for the first night after the procedure.
Where do I go and do I need to fast?
The Medical Imaging or Theatre Booking nurse will call you at home and inform you of the time to arrive and where to go. You will need to fast for 4 hours before the procedure and the nurse will inform you what time to start fasting when you are called.
You should take all of your usual medications before the operation. If you are taking blood thinner medications, such as:
- Aspirin (Cartia, Astrix)
- Clopidogrel (Plavix)
- Xarelto (Rivaroxaban)
- Other blood thinners
Please tell your kidney doctor as these medications are usually stopped before the procedure.
What do I need to tell the medical imaging or theatre booking nurse when I am called?
- You have diabetes
- You are taking a blood thinner medication.
A catheter fault includes:
- The caps come off
- The clamps break
- A hole or tear appears in the tube
Where do I go if this happens?
- During working hours: Call the renal unit as soon as possible.
- After hours: Go to the Emergency Department at the hospital