A dialysis catheter is a type of vascular access used for haemodialysis. It is inserted into a large vein, usually in the neck or upper chest, so blood can flow to and from the dialysis machine.
A Permacath, also called a tunneled dialysis catheter, may be used when haemodialysis is required and an arteriovenous fistula or graft is not available, not yet ready for use, or is not suitable for a particular patient.
A Permacath is a tunneled central venous catheter used to provide access to the bloodstream for haemodialysis.
Part of the catheter passes under the skin before entering a large vein. The external ends are used to connect the patient to the dialysis machine.
Catheters are generally used when a fistula or graft cannot be used immediately, although in some patients a catheter may be required for a longer period.
A dialysis catheter may be considered when:
The type of dialysis access should be chosen according to the patient’s kidney condition, blood vessels, expected duration of dialysis and overall clinical situation.
There are three main types of vascular access used for haemodialysis:
NIDDK lists these three access types and notes that dialysis access planning should ideally take place before haemodialysis is needed.
No.
A Permacath is a catheter placed into a large vein, while an AV fistula is created surgically by connecting an artery and a vein, usually in the arm.
The National Kidney Foundation notes that fistulas are generally preferred when possible because they tend to last longer and have fewer complications such as infection and clotting compared with catheters.
The exact technique depends on the clinical situation and the facility where the procedure is performed.
In general, the procedure may involve:
The procedure should be performed in an appropriately equipped setting by a trained medical team.
Ultrasound and/or fluoroscopic guidance may be used to help identify blood vessels and confirm catheter position.
Whether imaging is required depends on the type of catheter, insertion site, patient anatomy and treating team’s protocol.
Website information should avoid claims such as “100% accurate insertion” or “completely risk-free procedure.”
Dialysis catheter insertion is an invasive procedure and carries potential complications.
Possible risks may include:
Catheters have a higher risk of bloodstream infection than fistulas and grafts.
For detailed information about catheter-related infection, see National Kidney Foundation – Catheter-Related Bloodstream Infection .
A catheter-related bloodstream infection occurs when bacteria or other microorganisms enter through or around the catheter and spread into the bloodstream.
Possible symptoms can include:
The National Kidney Foundation states that catheter-related bloodstream infections can become serious and may lead to sepsis.
Catheter care is important because infection risk is higher with dialysis catheters.
General care may include:
The National Kidney Foundation advises patients not to open catheter caps on their own and to keep the dressing clean and dry.
Patients should follow the specific instructions provided by their dialysis team.
The catheter and dressing generally need to remain clean and dry. The dialysis team can advise how to bathe or shower safely according to the dressing type and catheter position.
Contact the dialysis or treating team promptly if you notice:
Urgent medical evaluation may be needed when infection is suspected or symptoms worsen.
Yes.
Blood clots or other problems may reduce blood flow through the catheter.
If dialysis staff notice poor blood flow, difficulty aspirating blood or repeated machine alarms, the catheter may require further assessment.
Patients should not attempt to flush or manipulate a dialysis catheter themselves.
There is no single fixed duration for every patient.
How long a tunneled dialysis catheter remains in place depends on:
Where possible, a fistula or graft may be considered for longer-term haemodialysis access.
Yes.
A tunneled dialysis catheter may be removed when it is no longer required, when another dialysis access becomes functional, or when there is a clinical reason to remove or replace it.
Removal should be performed by an appropriately trained healthcare professional.
A dialysis catheter does not treat the underlying cause of kidney failure. It provides access to the bloodstream so haemodialysis can be performed.
For information about kidney failure and chronic kidney disease, read Acute & Chronic Kidney Diseases .
For information about dialysis-related kidney care, see Nephrology Services .
If you have questions about dialysis catheter access, catheter care or kidney failure treatment, contact the clinic for consultation information and appropriate medical evaluation.
View Contact InformationA Permacath is a tunneled central venous catheter used to provide vascular access for haemodialysis when other forms of access are unavailable, not ready or unsuitable.
Not necessarily. The duration depends on the patient’s dialysis plan and whether another vascular access, such as an AV fistula or graft, becomes available.
No invasive procedure is completely risk-free. Possible complications include bleeding, infection, catheter blockage and other catheter-related problems.
Yes. Dialysis catheters have a higher risk of bloodstream infection compared with fistulas and grafts.
Source: National Kidney Foundation
Patients should not open catheter caps or manipulate the catheter unless specifically instructed by their dialysis team.
Source: National Kidney Foundation
Contact the team if you develop fever, chills, redness, swelling, pain, drainage, persistent bleeding, a loose dressing or problems with catheter function.
Source: National Kidney Foundation