Removal of a haemodialysis tunnelled catheter

Your doctor or nurse will have discussed with you that they need to remove your haemodialysis catheter. This leaflet explains why and how this is done.

Why am I having my tunnelled haemodialysis (HD) catheter removed?

There are many reasons why tunnelled HD catheters are removed, for example:

• It is no longer needed. For example, your fistula or graft is being used successfully for dialysis, or you no longer need dialysis.

• You have an infection in your catheter.

• Your catheter is not working properly.

Your doctor or nurse will explain why they need to remove your catheter. Please ask them any questions you may have.

Who will remove my catheter and where will it be removed?

A specialist nurse or doctor will usually remove your catheter on Marlowe Ward at Kent and Canterbury Hospital. But sometimes it will be removed in the Maidstone Renal Unit.

Will the procedure hurt?

You are given a local anaesthetic before this procedure, to numb the area. You may feel light pressure but it should not be painful.

Can I eat and drink?

Yes, you can eat and drink as normal on the day of your procedure.

Do I need to stop any medicines before my procedure?

No. You can take your normal medicines on the day of your procedure.

If you take Warfarin or other anti-coagulation medicine, the renal access nurse will tell you when to stop taking this.

How is the tunnelled dialysis catheter removed and how long will it take?

Your nurse or doctor will explain the procedure on the day.

The procedure involves a small incision (cut) above where the catheter exits your skin. You will have a few stitches, which your nurse or doctor will cover with a small dressing.

The procedure will take approximately 30 to 40 minutes. You will need to remain lying down for 30 minutes after your procedure. Please allow at least two hours for your appointment.

Will I need to change my dressing?

Keep your dressing dry for two days following your procedure. After that you can shower or have a bath, but keep a dressing over your wound until the stitches are removed.

You will be given spare dressings before you leave hospital. Please put on a clean dressing after showering or bathing.

Who will remove my stitches?

The haemodialysis nurse will remove your stitches 7 days after your procedure, when you come for dialysis. Or if you prefer, you can arrange for your GP practice to remove them.

Can I drive myself home after my procedure?

Yes, you will be able to drive yourself home after the procedure.

Are there any restrictions after this procedure?

• Rest for the remainder of the day.

• Do not carry out any strenuous work or exercise, or heavy lifting for 24 hours.

• You can still have your dialysis on the same day as this procedure.

What are the possible complications?

• Bleeding

  You can expect a small spot of blood on the dressing after your procedure. It is unlikely, but if your dressing becomes soaked with blood, apply firm pressure for 5 minutes. Use all your fingers, just above your collar bone on the side where the catheter has been removed. This should stop the bleeding. Your nurse will show you how and where to apply pressure before you go home. Your nurse will give you gauze pads to take home. If the bleeding has not stopped after five minutes, call Marlowe Ward on 01227 783100. If heavy bleeding continues, call 999.

• Discomfort

  Once the local anaesthetic wears off, the area may be sore for up to 12 hours. During this time, take paracetamol if needed, as directed on the packaging. Please avoid all anti-inflammatory medicines.

• The risk of infection to the area is very low. If you notice the area becomes hot, red, painful, or starts discharging pus, please contact your dialysis nurse or the access nurse. Their contact details are listed below.

Where can I find out more?

Please feel free to ring at any time for further information.

• Renal Dialysis Access Nurses, Kent and Canterbury Hospital, Canterbury
  Telephone: 01227 864305 (Monday to Friday, 8am to 4.30pm)

• Marlowe Ward, Kent and Canterbury Hospital, Canterbury
  Telephone: 01227 783100 (Out of hours or weekends)

• Thomas Becket Haemodialysis Unit, Kent and Canterbury Hospital, Canterbury
  Telephone: 01227 783047

• Haemodialysis Unit, William Harvey Hospital, Ashford
  Telephone: 01233 651872

• Haemodialysis Unit, Queen Elizabeth the Queen Mother (QEQM) Hospital, Margate
  Telephone: 01843 225544

• Haemodialysis Unit, Medway Maritime Hospital, Medway
  Telephone: 01634 825105

• Haemodialysis Unit, Buckland Hospital, Dover
  Telephone: 01304 222695

• Haemodialysis Unit, Maidstone Hospital, Maidstone
  Telephone: 01622 225901