Peritoneal dialysis catheter (PD catheter)

What is a peritoneal dialysis catheter?

A peritoneal dialysis catheter (which is often shortened to PD catheter) is a soft, plastic tube about 30–40 cm long, which is placed into the abdomen (tummy). A PD catheter is sometimes called a Tenckhoff catheter.

Part of the catheter sits inside the peritoneal cavity (or peritoneal space) inside the abdomen. This part has holes so fluid can easily move in and out. It may have one or more ‘cuffs’ that help to keep it in place. 

Part of the catheter sits outside the body and is taped to the skin. This part connects to the peritoneal dialysis machine.

The area where the catheter comes out is called the exit site. You and your child will be shown how to take care of the exit site and keep it clean, to avoid germs getting in and causing an infection.

Inserting a PD catheter

A PD catheter generally needs to be placed several weeks before peritoneal dialysis starts. This gives time for the body to heal around the catheter.

The procedure is usually done by a paediatric surgeon, who specialises in operations for babies, children and young people, and takes place at your child’s paediatric renal unit, a specialised unit for babies, children and young people with kidney conditions, which may be in a different hospital. It usually takes 1-2 hours, though your child will probably stay in the hospital for at least one night to recover. You can bring a change of clothes and some toys and books. 

Your surgeon will select the best type of surgery for your child. 

  • Laparoscopic surgery (also called keyhole surgery) – one or more tiny cuts are made in the abdomen. A long tube with a type of video camera is inserted so that the surgeon can see the inside of your child’s body on a screen and do the surgery.
  • Open surgery – a larger cut is made in the abdomen, so the surgeon can directly access the inside of your child’s body. Children usually need to stay in the hospital for a longer time to recover.

Preparing for surgery

Your child will be given a general anaesthetic, special medicine so he or she can sleep through the procedure and not feel any pain. This will be given as an injection or breathed in. The anaesthetist will speak to you about the best option for your child. You will be asked to give written consent, or permission, for the surgery.

Your child may be given antibiotic medicines to prevent infection.

Your child will be moved into an operating theatre, a room where surgery takes place.

After the surgery

Your child will go back to the ward, where he or she will be monitored by a healthcare team – this may be for one or two days, or longer. He or she will have a dressing over the catheter.

Your child may feel some effects from the anaesthesia, but these do not usually last long. They include feeling sick and being sick (vomiting), headache, sore throat, or feeling dizzy or light-headed.

Your nurse will give your child some medicines to help with any pain from the surgery.

Going home

The dressing over the catheter will need to stay on until the cut is fully healed – this may take up to 4 weeks, and sometimes longer. The dressing must be kept clean and dry. The renal nurses – nurses who care for children with kidney problems – will give you guidance about dressing changes and what to do when you leave hospital 

Risks

All surgery has some risks, but these are very rare. 

  • There is a risk of infection. Antibiotic medicines may be needed to treat the infection. 
  • Occasionally, children bleed from the cut. If this happens your child may need to go back to the operating theatre.
  • Sometimes the PD catheter does not work. Your child’s healthcare team will look for any problems. If these happen, surgery and/or a new catheter may be needed.

Taking care of the PD catheter

You and your child will be shown how to look after his or her catheter – to keep it clean to reduce the risk of infection, and to make sure the catheter stays taped to his or her body so it does not get dislodged or caught in clothing.

There is a cap on the end of the catheter, which is only removed during dialysis. Make sure that you, your child or anyone else does not remove or touch the cap. If this happens, contact your renal unit.