Ideally, a nephrologist or kidney doctor will monitor patients with kidney disease. The kidneys are responsible for filtering toxins from the bloodstream as well as controlling the amount of various ions in the blood, such as sodium, potassium, and chloride. If a patient’s renal function begins to decline, a vascular surgeon will place a fistula or other form of long-term dialysis access prior to starting dialysis. Dialysis machines filter a patient’s blood of toxins and help regulate electrolytes. Patients usually require more than four hours of treatment three times per week.
For patients with a rapid decline in renal function a fistula is often not placed in time or not yet ready for use. Hospitalized patients require a dialysis catheter for treatment. Temporary, non-tunneled catheters can be placed at the bedside with or without ultrasound guidance. Catheters are placed in the femoral or jugular veins. Long-term, tunneled catheters can be used as a bridge to a functional fistula or other dialysis access.
When people think about using a catheter to establish access to the bloodstream, most people think of a peripheral IV. Catheters used for dialysis are much larger than a peripheral IV or standard central line. Temporary dialysis catheters are ideally used for less than a week before being replaced. Long-term catheters are tunneled under the skin and have a small cuff of material around the end of the catheter. This is embedded under the skin when the catheter is tunneled into place and helps prevent catheter movement.
Patients should remember that the catheter site will need care and cleaning. The catheter is a connection between the internal blood vessels and the outside world. It the site becomes infected, the infection can enter the bloodstream and the patient can become septic or even die. Finally, there is always a chance that the dialysis catheter can become blocked with a blood clot. Sometimes the catheter can be treated with medication to dissolve the clot. Other times, the catheter can be exchanged for a new one over a wire. Unfortunately, if this is unsuccessful the dialysis catheter will need to be replaced all together.
Patients who are requiring placement of a dialysis catheter should trust an experienced double board-certified general and vascular surgeon who will minimize the risks of these complications. Dr. Jenna Kazil is talented double board-certified vascular and general surgeon who has a massive amount of experience placing dialysis catheters at various area hospitals. Dr. J. Kazil is a skillful surgical specialist working as a general and vascular surgeon seeing patients from North Hillsborough to West Pinellas and Manatee to South Sarasota to East Hardee and Desoto counties. Contact the Florida Surgical Clinic today to meet with Jenna Kazil, MD, RPVI!