Haemodialysis (HD) is a form of treatment for chronic kidney disease (CKD). A dialysis machine circulates blood from your body through the machine and filters it to remove the toxins and excess fluid that have built up because your kidneys are not working as well as they should do. This can be done using a haemodialysis line.
This page explains what a haemodialysis line is and how to look after it.
What is a haemodialysis line?
A haemodialysis line, also called a central venous catheter, is a soft plastic tube which is inserted into one of the large veins in your neck or, occasionally, in your groin. This tube gives your dialysis team access to your blood, so that it can circulate around the HD machine to be filtered.
The tube is about the width of a standard pencil and twice as long. It will pass under your skin for a short distance, to the front of your chest (if it goes in through your neck), or the front of your thigh (if it goes in your groin), before coming out of your skin. The external part of the line may be kept in place with stitches. The part of the line running under your skin has a small cuff of material on the inside which helps your body to form scar tissue. This helps to reduce the risk of infection and keep the line in place.
For more information see our leaflet on Inserting your tunnelled haemodialysis catheter (permcath).
How can I look after my haemodialysis line?
It is important that you take care of your haemodialysis line to prevent infections and to make it last longer.
Avoid touching the line where it goes into your skin. If you do need to touch it, always wash and dry your hands before and after touching it.
The dressings around the insertion and exit sites of the line must be kept dry at all times. You should not have a shower until the wound heals and the stitches are completely dissolved or removed. Removal of any stitches usually happens around 14 days after you have your line inserted.
After the stitches are removed, you can take a shower, but make sure that the exit site is kept dry. Special pouches are available to protect the line while you shower. Please ask your dialysis nurse if you would like to try these as they may be able to provide them for you.
You will need to apply a new dressing after you shower. You can get these from your dialysis nurse who will also teach you how to apply them.
Always wash your hands thoroughly before you put on a new dressing.
- Covering your line and exit site under water increases the risk of infection, so taking a bath and going swimming is not recommended.
- Your dialysis nurses will usually change your dressing once a week. Let them know if you have changed your own dressing in between or if the dressing feels itchy or uncomfortable.
- Do not use any creams or talcum powder around the haemodialysis line.
- Wear clean, loose-fitting clothes around your line and take care when dressing and undressing to avoid pulling on the line.
- It is advisable to wrap and tape a clean piece of gauze around the line when it is not in use. Your dialysis nurse will show you how to do this.
- Keep sharp instruments like scissors away from your line.
- Do not pull or tug on your dialysis line.
- Do not allow anyone other than a member of your kidney team to use your line.
How can I tell if something is wrong with my haemodialysis line?
Your nurses will check your line’s exit site for signs of infection each time you go for dialysis. Infections can often be treated with antibiotics but, if they are severe, your haemodialysis line may need to be removed.
Important!
Contact your kidney unit immediately if you notice any of the following as they may be symptoms of infection:
- A higher temperature than normal, fever, chills or shivering.
- Pain, itching, redness or swelling around the exit site
- Discharge (e.g. blood or pus) from around the line
- Cracks or leaks in the line
If there is severe bleeding, or your line falls out, press on the insertion site (not the exit site) with a clean hand towel and call 999 for help or ask someone to take you to your nearest Emergency Department.
What happens when I don’t need the haemodialysis line anymore?
If you have stopped receiving dialysis or are having haemodialysis through a fistula (a more permanent connection that is made by joining a vein onto an artery, usually in your arm), your haemodialysis line will be removed at your kidney unit.
For more information see our leaflet on Removing your temporary haemodialysis catheter (vascath).
Where can I find more information?