Patient education: Peritoneal dialysis catheter placement – Discharge instructions (The Basics)

What is a peritoneal dialysis catheter? — A peritoneal dialysis, or "PD," catheter is a thin, flexible tube used to get the 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 PD catheter in place.

After getting a catheter placed, it usually takes about 2 weeks for the body to heal. Your doctor will talk to you about when you can start dialysis.

How do I care for myself at home? — Ask the doctor or nurse what you should do when you go 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.

Your doctor or nurse will talk to you about your PD catheter. They will show you how to care for it. They will also make sure that you have the supplies you need. Having a PD catheter increases your risk of infection. This is why it's so important to take care of it.

For the first 24 hours after surgery:

●Do not drive or operate heavy or dangerous machinery.

●Do not make any important decisions or sign any important papers.

●Do not drink alcohol of any kind.

You should also:

●Take all of your medicines as instructed.

●Take care of your incision – You might have stitches, skin staples, surgical glue, or a special skin tape on your incision. If you had minimally invasive surgery, you might have more than 1 incision.

For the first 2 weeks, or until the skin around the catheter is healed:

•Keep your incision dry and covered with a bandage after surgery. The dialysis team will change your dressing as needed. They will also flush the catheter if needed.

•You can wash around the dressing with a washcloth, but do not take a shower or bath until your dialysis team says that you can.

•Do not put your incision underwater, such as in a bath, pool, or lake. This can slow healing and raise your chance of getting an infection.

•Always wash your hands before and after you touch your catheter, incision, or bandage.

●Increase your activity slowly – Start with short walks around your home, and walk a little more each day.

•Avoid heavy lifting, sports, and swimming for at least a few weeks. (Your doctor or nurse will tell you exactly how long to avoid these or other activities.)

●Eat when you are hungry – If you have an upset stomach, it might help to start with clear liquids and foods that are easy to digest, like soup, pudding, toast, or eggs. You can eat other types of foods when you feel ready. If your doctor or nurse gave you specific instructions about what to eat or avoid, follow them.

●Use a stool softener to help prevent constipation, if needed. This is a common problem if you take opioid pain medicines. Follow all instructions for taking your pain medicines.

●Take non-prescription medicines such as acetaminophen (sample brand name: Tylenol) to relieve pain. This can be used instead of opioids. Avoid "NSAID" medicines, unless your doctor says that you can take them. This includes ibuprofen (sample brand names: Advil, Motrin) and naproxen (sample brand name: Aleve). NSAIDs can harm the kidneys.

●Be aware that if you had minimally invasive surgery, you might have some pain in your shoulder. This is from gas that the doctor put into your belly during surgery. Walking and moving around will help reduce the gas and ease pain.

What follow-up care do I need? — The doctor will want to see you again after surgery to check on your progress. Go to these appointments.

If you have stitches or staples, you might need to have them taken out. Your doctor will usually want to do this in 1 to 2 weeks. Some stitches absorb on their own and do not need to be removed. If the doctor used skin glue or skin tape, it will fall off on its own. Do not pick at it or try to remove it yourself.

What else should I know?

●You can wear a special belt to help hold the PD catheter in place. Or you can use tape to keep it secure.

●Keep sharp objects away from the catheter.

●The dialysis nurse might flush your catheter.

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

●You have symptoms of infection, like:

•A fever of 100.4°F (38°C) or higher, or chills

•Redness, drainage, warmth, stinging, or pain where the catheter goes into your skin

●There are problems with the catheter, like:

•It falls out all the way or part of the way.

•There are breaks, cracks, or leaks in it.

•You have any concerns about it.

More on this topic

Patient education: Peritoneal dialysis catheter placement (The Basics)
Patient education: How to care for a peritoneal dialysis catheter (The Basics)
Patient education: Peritoneal dialysis (The Basics)
Patient education: Chronic kidney disease (The Basics)

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