Patient education: How to care for a peritoneal dialysis catheter (The Basics)

What is a peritoneal dialysis catheter? — A peritoneal dialysis ("PD") catheter is a thin, flexible tube used to get fluid in and out of the belly for dialysis (figure 1). One end of the tube stays in the belly. The other end stays outside of the body. There are often 1 or 2 "cuffs" under the skin to help hold the catheter in place (figure 2).

After getting a catheter placed, it usually takes about 2 weeks for your body to heal. Your doctor will talk to you about how long you need to heal before you can start dialysis.

How do I care for myself at home? — Make sure that you understand exactly what you need to do to care for yourself. Ask questions if there is anything you do not understand.

●Before you go home, your doctor or nurse will talk to you about the kind of PD catheter you have. They will show you how to care for it, including changing the dressing. They will also make sure that you have the supplies you need.

●You might need a family member or friend to help you care for the PD catheter. Some people have a home health nurse come to their home to help with this.

Having a PD catheter increases your risk of infection. This is why it's so important to take care of it.

How do I keep the skin around the PD catheter clean? — Keeping your skin clean and changing the dressing regularly can help prevent infection. Always change the dressing right away if it is loose, wet, or dirty.

After your skin is healed around the catheter, you might need to change your dressing every day or every other day.

Once the area has healed, you will need to clean your skin and change the dressing:

●Gather the supplies, and place them on a clean workspace. You need a mask, clean gloves, cleaning solution like chlorhexidine or saline, sterile dressing, and tape.

●Always wash your hands well with soap and water before touching the catheter. This helps to avoid spreading germs. Wear a mask when changing the dressing. If another person is helping with the dressing change, they should also wear a mask. You might want to wear clean gloves when taking off the old dressing.

●Take off the old dressing, if you have one. Avoid using scissors or sharp tools. They could cut the catheter. Do not pull on the catheter when taking off the dressing.

●Check your skin where the catheter enters for swelling, drainage, or redness.

●Wash your hands again. Put on clean gloves.

●Hold the catheter, and clean your skin with the cleaning solution. Use a back-and-forth motion, and clean for 30 seconds. Starting at where the catheter enters your skin, wash the catheter, and wash your skin moving outward. Clean the entire area that will be under the dressing, about a 4-inch (10-cm) square. Do not pick or remove crust or scabs. Let the cleaned area air dry for at least 30 seconds.

●In some cases, your doctor or nurse will give you an antibiotic ointment to help prevent infection. Put a small amount of the ointment on your skin around where the catheter exits.

●Lay the catheter on your skin in a loose circle if it is long, or in a straight line if it is short. It should not lie on top of where it goes into your skin or on itself. If you use a dressing, place a sterile piece of gauze over where the catheter goes in. Cover the gauze and catheter with a special tape that allows the skin to get air. If the tape is not sticking, talk to your doctor or nurse about other dressing materials.

●Throw away the old dressing and used swabs and wipes.

●Remove your gloves, and throw them away.

●Wash your hands with soap and water.

What else should I know? — Some people wear a special belt to help hold the PD catheter in place.

While the catheter is in, you should:

●Avoid contact sports or rough play. Avoid strenuous exercise for the first month after the catheter is placed.

●Keep sharp objects away from the catheter.

●Avoid swimming in ponds, lakes, rivers, ocean, pools, or hot tubs. Take a shower instead of a bath.

●Keep the dressing covered when showering. Change the dressing if it gets wet or dirty, or becomes loose.

●Make sure that the catheter is secured with special holders or tape.

●Keep the catheter clamped, if it has one, when it is exposed to air. For example, it should be clamped when connecting to the dialysis tubing or when you are changing the cap. The doctor or nurse will teach you when and how to clamp the catheter correctly.

●Check for signs of infection every day.

When should I call the doctor? — Call for advice if:

●You have symptoms of infection. These include a fever of 100.4°F (38°C) or higher, chills, or redness, drainage, warmth, stinging, or pain where the catheter goes into your skin.

●There are problems with the catheter, like:

•The catheter falls out all the way or part of the way.

•There are breaks, cracks, or leaks in the catheter.

•Fluid does not flow through the catheter.

•You have any concerns about the catheter.

●The dialysis fluid looks cloudy or is a different color after draining.

More on this topic

Patient education: Peritoneal dialysis catheter placement (The Basics)
Patient education: Peritoneal dialysis (The Basics)
Patient education: Chronic kidney disease (The Basics)
Patient education: Dialysis and diet (The Basics)

Patient education: Peritoneal dialysis (Beyond the Basics)
Patient education: Chronic kidney disease (Beyond the Basics)