Peritoneal Dialysis Catheter Placement
What is PD Catheter Placement?
Before you can begin peritoneal dialysis (PD) treatments, you need to have a peritoneal dialysis (PD) catheter placed as an access for the removal of waste and toxins from your body. A PD catheter, the only type of dialysis access used for PD, is placed through your abdomen and into the peritoneal space through the peritoneal membrane—the thin membrane that lines your abdominal wall.
Learning the ins and outs of the placement procedure can help put you at ease. Here’s everything you should know:
How is PD Catheter Placement Performed?
PD catheter placement is typically performed as a minimally invasive procedure in an outpatient setting, which is far less invasive than surgery. Percutaneous catheter placement is performed using fluoroscopy—an imaging technique that uses X-rays to help your vascular specialist view the inside of your abdomen. This procedure requires only local anesthesia and sedation.
Your vascular specialist begins by using a fine needle to make a series of small punctures in your skin to access the peritoneum. The PD catheter is then passed through a small tunnel in your belly into the peritoneum and secured in place.
A PD catheter is made of silicone or another soft, flexible medical-grade material. Your catheter will have cuffs on it to prevent it from shifting and moving around, and that helps keep bacteria out of the tunnel and exit site. The PD catheter exit site is typically placed to the left or right of your belly button, you should discuss your personal placement preferences with your vascular specialist. As you recover, your tissue will grow around and fill in part of the exit site as well to prevent the catheter from moving.
After the PD catheter has been inserted, your vascular specialist will place sutures around the catheter on the outside of your abdomen and cover the site with a sterile dressing.
PD catheter placement can usually be performed in under one hour. However, you may spend additional time in the recovery room before going home so your vascular access team can monitor you for complications after the procedure.
Prior to Your Procedure
Your vascular specialist will give you detailed instructions regarding what you can and cannot do prior to PD catheter placement. Follow your pre-op instructions as closely as possible to reduce your risk for infection and other complications during this procedure.
Post Procedure & Follow Up
You may experience mild pain, discomfort, loss of appetite, and fatigue following PD catheter placement. All of these symptoms are normal and will eventually resolve on their own within a few days.
Keep your dressing dry at all times and do not shower or expose your access site to water without approval from your doctor. Do not remove the dressing covering your access site, since this could expose your healing wound to bacteria and increase the risk for infection.
Contact your doctor immediately if you experience warmth, swelling, redness, or discharge at the access site. These signs can indicate a possible PD catheter infection.
Caring for your PD Catheter
Proper catheter care can prolong the life of your catheter and help you stay healthy for as long as you need PD. Don’t hesitate to ask your vascular specialist for help and guidance with using and caring for your PD catheter. PD is linked to a high risk for infection at the catheter exit site, in the tunnel for the catheter, and in the peritoneum. This type of abdominal infection is known as peritonitis.
Follow these rules for PD catheter care to reduce your risk for peritonitis:
- Wash your hands thoroughly with soap and water before and after handling your catheter.
- Clean your access site every day to eliminate bacteria.
- Store your dialysis supplies in a clean, dry, and cool place.
- Perform dialysis in clean, dry places that are well lit to reduce contamination risk.
- Wear a surgical mask each time you open the end caps of your PD catheter.
- Thoroughly inspect every bag of solution for signs of cloudiness and contamination before use.
- Avoid wearing tight, restrictive clothing and belts near the access site.
- Keep sharp objects like scissors away from your catheter at all times.
- Keep the catheter taped against your skin to prevent it from catching on clothing and other objects.