Take Ownership of
Your Hemodialysis

Regardless of whether you use an AV fistula, graft, or dialysis catheter for your hemodialysis access, it's important to know how to care for it, and how to know when something is wrong.

Starting Hemodialysis On a Catheter

It is important to take proper care of your catheter which can help you avoid infection and receive effective hemodialysis treatments.

Starting Dialysis on a catheter video

Sometimes hemodialysis catheters will not function properly. A malfunction occurs when the catheter becomes clogged preventing normal blood flow through the catheter. You may also experience an infection. Bacteria will grow naturally on your skin. Under certain conditions they can cause an infection if they enter your body through the exit site. In either case, a physician may need to intervene.


Clots: a blockage in the openings of the catheter, that can occur on the inside or outside of the catheter. Clots can cause slower blood flow during treatment which can lead to inefficient dialysis and potentially cause you to need longer than usual treatment sessions in order to receive adequate dialysis. The catheter should be checked if low flow rates persist for more than one dialysis treatment. Alarms on the dialysis machine help the technicians determine how your catheter might dysfunction during treatment and help them to better inform your physician about the problem at hand.


Infection: even with proper blood flow, infections can occur. Following strict care and cleaning instructions is the best way to prevent infection. The signs and symptoms of catheter infection include: fever; chills; drainage from the exit site; general feeling of weakness/illness. You should know and be aware of these symptoms so that if you ever experience them, you can notify your nurse or physician right away to get treatment as quickly as possible.

What can I do to keep my catheter working well?

Catheters can stay in place for weeks, months or even years if they are properly cared for. Always follow any specific instructions from your doctor or nurse.


Wash Your Hands Often

  • Wash your hands often
  • Try not to touch the catheter or dressing
  • Keep your catheter clean and dry
  • Do not use sharp objects or scissors near your catheter
  • Take care not to pull or twist your catheter when getting dressed or undressed, removing a blanket, or changing the dressing
  • Be careful when lifting small objects, children, or pets

Keep Your Catheter Clean and Dry

Bacteria grow naturally on your skin. Under certain conditions they can cause infection if they enter your body through the exit site. You should always keep the exit site covered with a sterile dressing or bandage. The dressing should be replaced if it gets dirty, becomes wet, or is no longer sticking to the area around the exit site. Ask your doctor or dialysis nurse for instructions on caring for your catheter at home, including how to change your dressing at home. Keep an extra dressing kit available in case you need to change your dressing in between treatments.


Avoid Showering or Swimming

Avoid showering, swimming or any activity that may cause your catheter or catheter dressings to become wet. Any type of moisture may cause or accelerate infection. Your doctor may allow you to bathe, but you must be careful not to get the catheter, exit site or dressing wet. If approved by your doctor, the exit site must first be covered with a waterproof dressing.


Clamping Your Catheter

Each lumen should be clamped shut and with the cap tightly screwed on whenever the catheter is not in use. Your catheter should also stay clamped when changing the caps or when connecting the tubing for dialysis to your catheter. This keeps blood from leaking out or any bacteria or air from getting into your body. If your catheter clamp breaks or end cap comes off, contact your doctor immediately and follow his/her instructions. It is helpful to always have an extra end cap available.


Prevention is Key

If you have any questions, or if you notice anything unusual such as redness or swelling, pain or fever, or a damaged or broken catheter, call your doctor or nurse immediately. It is always easier to care for a problem if it is handled early. You can make a difference!


Possible Problems

  • Skin irritation over the tissue ingrowth cuff
  • Loose or disconnected end cap
  • Infection
  • Swelling of neck and arm on side of catheter insertion (central vein thrombosisa blood clot in a vein near your chest or blood clot possible)
  • Swelling of the leg or feet - femoral placementcatheter placement in the leg (central vein thrombosis or blood clot possible)
  • Swelling at exit site
  • Break or accidental cut in catheter
  • Air in the lung space (pneumothorax)
  • Air in catheter (air embolism)