What is Dialysis?
Dialysis is a procedure that is routinely performed on patients diagnosed with acute / chronic renal failure, or end-stage renal disease. The process involves removing waste substances and fluid from the blood that are normally eliminated by the kidneys. During dialysis treatment, the patient is connected to a machine by way of a flexible plastic tube that pumps blood from the body, cleans it and safely returns it to the body through a separate tube. This is known as dialysis access and often referred to as the “lifeline.”
Types of Dialysis Catheters
- Tunneled Catheter: A tunneled catheter is passed through a vein under the skin from an insertion site to a separate exit site, where the catheter and its attachments emerge from underneath the skin. The entrance site is most commonly placed in the neck (jugular) but may also be placed in the groin (femoral), or chest (subclavian).The exit site is typically located in the chest, making the access ports less visible than if they were to directly protrude from the neck. Passing the catheter under the skin helps to prevent infection and provides stability for long-term use. Tunneled catheters are considered “permanent” because they can remain in place from seven days to twelve months.
- Non-Tunneled Catheter: A non-tunneled catheter is considered “temporary” and does not pass through a vein to a separate exit location. Like the tunneled catheter, the entrance site can be in the neck (jugular), groin (femoral), or chest (subclavian). Patients that require non-tunneled catheters are at risk of injection at the entrance site so care must be taken to keep the area clean. Non-tunneled catheters are considered “temporary” because they only remain in place for a few hours or days.
Dialysis Catheter Placement
Most vascular access procedures can be performed on an outpatient basis, under local anesthesia. The anesthesiologist may administer some sedative medication to allow the patient to be relaxed and drowsy, but general anesthesia is usually not required.