Your kidneys play a vital role in your health and wellness. These small but essential organs are necessary for your survival, as they filter out wastes and toxins from the bloodstream for disposal. Unfortunately, kidney failure can occur, especially in patients with:
- Chronic or poorly managed diabetes
- Long-term or severe hypertension (high blood pressure)
- Poor lifestyle habits, including smoking and alcohol use
- Genetic conditions and predispositions to kidney disease
When this happens, your body needs a backup to remove those waste products, which are fatal if left to accumulate in the body. That’s where dialysis comes in. For many people, dialysis catheter placement helps keep them alive and healthy until the body can repair itself or other treatment options, such as kidney transplants, become available.
What Is the Purpose of Dialysis Catheter Placement?
Kidney dialysis is rarely a “one-and-done” situation. Your body needs help removing wastes on a daily basis until either the kidneys resume their normal function or you acquire a new kidney. This procedure uses a series of tubes, pumps, and machines to slowly remove the blood, filter out the waste products, and then return it to the body for continued circulation, a process known as hemodialysis.
A dialysis catheter can be a literal lifesaver. It helps remove the blood from the body safely while keeping all fluids completely sterile and contained. The surgeon inserts this small tube in a specific location to allow the blood to exit and re-enter the body at a steady rate so you can maintain adequate blood and oxygen supply to all of your tissues and vital organs.
Who Places Dialysis Catheters?
Technically, dialysis catheter placement qualifies as surgery. It requires a sterile technique and incredible precision to ensure proper placement without causing irritation or discomfort to the patient. Most patients are awake for the procedure, only requiring local or topical numbing solutions rather than general anesthesia. Only a trained expert surgeon can insert or remove a dialysis catheter.
How Long Should a Catheter Be Left in for Dialysis?
Manufacturers designate some dialysis catheters for short-term use in emergency situations with acute kidney disease. These remain in place for no more than three weeks in total. However, chronic kidney issues can require long-term treatment. Catheters used in these situations can better withstand wear and tear and resist infection. Depending on the patient’s needs, a catheter can stay in place for months or years before removal or replacement.
A physician helps determine just how long dialysis treatment should last. In the meantime, patients can take steps to ensure their catheter lasts by keeping the area clean and dry, following recommendations for dressing changes, and never skipping appointments for assessment, cleanings, or treatments. Patients should also report new pain, signs of infection, or changes to the site immediately.
Does a Dialysis Catheter Placement Occur in a Vein or Artery?
Arteries carry oxygenated blood away from the heart to distribute to the rest of the body. Veins return deoxygenated blood to the heart to begin the circulation process again. To function as naturally as possible with this cardiovascular system, dialysis catheters have two openings: one placed inside an artery, and the other in a nearby vein.
Once the healthcare provider initiates the dialysis process, blood flows through the artery opening of the catheter and into the dialysis machine for waste elimination. The filtered blood then returns through the vein, where it travels to the lungs and heart for oxygenation and redistribution.
Where Is a Dialysis Catheter Placed in the Neck?
The optimum site for dialysis catheter placement can vary from person to person. Multiple members of the healthcare team work with the patient to make the best choice based on preexisting medical conditions, overall comfort, risks for complications, and other factors. Alternative dialysis options include peritoneal dialysis and graft or fistula placement. These are more of a permanent solution for patients who may need dialysis long-term because recovery from kidney failure is unlikely.
A peritoneal dialysis catheter is placed in the abdomen, usually near the belly button. These allow for nearly constant dialysis and may be a solution for patients who cannot wait a full day between treatments or wish to avoid daily dialysis appointments. Grafts or fistulas are usually placed in the forearm for quick and easy access to dialysis machines. In some rare cases, surgeons place a catheter in the thigh at the femoral artery. However, the risk for infection is higher here, so it tends to be a last resort.
Emergency or short-term dialysis catheter placement often occurs in the neck. It may also be the best option for long-term placement if other locations are not viable. The surgeon may access the circulatory system via the jugular vein (directly in the neck) or the subclavian vein (just below the clavicle, in the chest). Both of these veins are large, making it easier to ensure an accurate and more comfortable result. Which vein they choose can depend on patient preference but more so on the overall health and structure of the blood vessel itself.
What Are Possible Problems With Dialysis Catheters?
Any long-term medical device comes with some risks. However, these are often managed easily with proper care and lifestyle habits. Because catheters create an opening in the body, they provide a new access point for bacteria. Therefore, infection is a common concern. Proper hygiene and dressing changes help diminish this risk.
Clots are another problem that can develop near the site of the catheter. Most dialysis patients follow a medication regimen to address this. Even with proper care, complications may still arise. If necessary, a surgeon can remove and replace a dialysis catheter so treatment can continue safely and efficiently.
Where Should You Go for Dialysis Catheter Placement?
When you need dialysis catheter placement, you need a knowledgeable surgical team you can trust, with a wealth of expertise and success. At Arizona Premier Surgery, these types of procedures are our specialty. Healthcare surgery and procedures are all we do, so we can focus on the details that make all the difference for patients. Contact us today to learn more about how we can help make your preparations for dialysis treatment as smooth and easy as possible.
Sources:
https://www.kidney.org/atoz/content/hemocatheter
https://www.kidneyfund.org/all-about-kidneys/kidney-failure-symptoms-and-causes