Tunneled Dialysis Catheter Placement
by Cynthia M. Johnson, MA
Tunneled dialysis catheter placement inserts a tube (catheter) under the skin and into a major vein.
The tube has two openings. The blood leaves the body through the red opening. It is filtered and cleaned through dialysis. The cleaned blood returns through the blue opening.
Reasons for Procedure
This procedure is done to allow quick access to blood flow to do dialysis. Dialysis is a process that filters and cleans the blood when the kidneys can no longer do this on their own.
People who have this catheter do not need to have multiple needlesticks at every dialysis visit. This lowers the risk of infection and damage.
Problems are rare, but all procedures have some risk. The doctor will go over some problems that could happen, such as:
Things that may raise the risk of problems are:
What to Expect
Prior to Procedure
The surgical team may meet with you to talk about:
The doctor may give:
Description of the Procedure
An ultrasound and x-rays using contrast material will be used to help locate the vein. It will also help put the catheters in place.
A small incision will be made in the lower neck. The doctor will access the jugular vein in the neck with a needle and pass a small guidewire into the vein. The guidewire will be passed to a larger blood vessel called the vena cava.
A second incision will be made in the chest below the first incision. A tunnel will be made just under the skin between the first and second incisions. The flexible dialysis catheter is then passed from the second incision, through the tunnel, to the first incision site. This is where it is passed over the guidewire and into its final position. The guidewire is removed from the blood vessels. The other end of the catheter will remain outside of the body, extending through the second incision. The doctor will make sure that blood is flowing in the catheter.
Correct catheter placement can be checked with x-rays. The catheter will be secured with stitches. Some catheters have a cuff that sits in the tunnel under the skin. This cuff helps keep the tube secure and free of infection. The first incision will be closed. It may be closed with stitches, tape, or a type of medical glue. The second incision will be stitched around the catheter to help it stay in place. Both areas will be bandaged.
How Long Will It Take?
Less than 1 hour
Will It Hurt?
Pain is common in the first few days. Medicine and home care can help.
At the Care Center
The staff may give you medicine to ease pain.
During your stay, staff will take steps to lower your chance of infection, such as:
You can also lower your chance of infection by:
Recovery can take 2 to 4 weeks. You may need to ask for help with daily activities. Some physical activities may need to be limited during this time.
Call Your Doctor
Call the doctor if you are not getting better or you have:
If you think you have an emergency, call for medical help right away.
National Institute of Diabetes and Digestive and Kidney Disorders
National Kidney Foundation
The Kidney Foundation of Canada
Hemodialysis. National Institute of Diabetes and Digestive and Kidney Disorders website. Available at: https://www.niddk.nih.gov/health-information/kidney-disease/kidney-failure/hemodialysis. Accessed September 16, 2020.
Hemodialysis catheters: How to keep yours working well. National Kidney Foundation website. Available at: https://www.kidney.org/atoz/content/hemocatheter. Accessed September 16, 2020.
Vascular access procedures. Radiological Society of North America Radiology Info website. Available at:
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Accessed September 16, 2020.
Last reviewed March 2020 by EBSCO Medical Review Board Shawna Grubb, RN