It is important that you follow the advice provided in this leaflet to help protect your dialysis access and support its healing. If you have any questions or concerns before or after your procedure, please contact your renal access team or the healthcare professional caring for you.
Our aim is to ensure that you feel informed, prepared and supported throughout your treatment, and understand how to care for your dialysis access.
What is a PD Catheter?
A Peritoneal Dialysis (PD) Catheter (sometimes called a Tenckhoff Catheter) is a small tube that is inserted into the abdominal cavity (space around the organs within your stomach) and has cuffs to hold it in place.
Some of the catheter sits on the outside of the body. It is soft to touch and feels quite comfortable when taped against your skin. The PD Catheter is used to infuse fluid (called dialysate), to hold it inside (dwells) and to drain it out of your abdomen.
What do I need to do before the procedure?
When you are ready to start Peritoneal Dialysis, which has already been discussed with you by the pre-dialysis team, you will receive a letter asking you to attend a Pre-Assessment Clinic at Leeds General Infirmary. At this appointment you will be seen by a Pre-assessment Nurse and Anaesthetist.
Preoperative preparations will also take place such as physical examination, chest x-ray, ECG, blood tests, and MRSA swabs. Fasting instructions will be given as you will not be allowed to eat and drink from 12 midnight the night before the procedure.
You will also be seen by a Peritoneal Dialysis nurse who will look at your abdomen and decide where to place the catheter and will mark your skin.
The nurses will also talk to you about the following:
- Decolonisation treatment – This is normally given five days pre-operatively to reduce the risks of infection.
- Bowel preparation – These are laxatives to be taken five days before your surgery and to continue after your surgery. Taking prescribed laxatives before and after the catheter is inserted keeps the stool soft and prevents constipation, which reduces the risk of the catheter moving out of position or failing to drain (you will be given a prescription by the Peritoneal Dialysis Team).
- Information regarding care of your wound and exit site dressing post-surgery and up to starting PD training. You will be given post operative information after your surgery by the peritoneal dialysis team. Do not get the surgical dressing wet or remove the dressing until the peritoneal dialysis team evaluates and instructs you.
This is also an opportunity for you to discuss any questions or concerns you may have.
What happens on the day of the procedure?
On the day of the procedure, you will report to David Beevers Day Unit (DBDU) at St James’ University Hospital, or L34 at Leeds General Infirmary for 07:15am.
A nurse, anaesthetist and surgeon will see you and you will be asked to sign a consent form. Please bring all your medication with you.
How is a PD Catheter inserted?
A surgical operation under general anaesthesia is required to insert the catheter into your abdomen. You will have a small incision just below your umbilicus.
The catheter will exit on the previously marked site either to the right or left. The procedure will last for about an hour and will normally be carried out as a day case.
What happens after the procedure?
After the procedure, you will be monitored on the ward for the rest of the day. You will usually be sent home in the evening of the procedure.
Important
You must be with a responsible adult who will look after you at home for the first 24 hours after you have your operation.
Your wound will also be checked and your dressing changed. Make sure your catheter is always taped securely to your abdomen to avoid any pulling or damage to exit site.
Important
You should call the PD department immediately if you notice a lot of bleeding from your exit site.
You will be asked NOT to do the following:
- Do not touch your dressing until seen by a PD nurse.
- Do not drive for around six weeks.
- Do not shower for 14 days to allow healing and to prevent infection.
- Do not do any heavy lifting or strenuous physical activity.
- Do not wear tight or restrictive clothing and belts.
- Use stairs with caution, moving slowly and steadily to avoid sudden strain on your abdomen.
You are also advised to continue taking laxatives as constipation prevents the flow of dialysis fluids which results in training being delayed. However, if you have relatively loose stool please contact the PD Unit.
Your training will be discussed with you on your first visit to the pd unit. If you require transport for this, please contact PD staff at least four working days before your training.
You are also advised to stay off work between two and six weeks after your operation, depending on the nature of your job. Please consult the PD team for specific advice.
When can my PD Catheter be used?
Generally, you can use the PD Catheter 10 to 14 days after insertion to allow the catheter site to fully heal. However, this varies according to your blood results and how you are feeling.
