When we think about the care of dialysis catheters. There are two kinds of dialysis catheters.

Here we will focus on each, one by one:-

How to take care of a hemodialysis catheter.

By taking good care of your access, it will last longer and you will be able to deter problems such as infection and clotting.            

Here are some significant steps to take:

• Keep the catheter dressing neat and dry.
• Make sure the location of the insertion site is clean and your supervision team changes the dressing at each dialysis session.
• Keep an emergency dressing kit at residence, in case you require to change your dressing in between treatments. Inquire your dialysis care team to teach you how to change dressings in an emergency.
• Never remove  the cap on the verge of your catheter. Air must not inject into  the catheter.
• You can shower or bathe if you have an obvious dressing that sticks to your catheter site and the skin around it.  This kind of dressing is advised because it’s waterproof, which enables it to prevent infection.  And because it’s obvious, you can see signs of infection.  
• You should resist  letting the catheter or catheter site go under water during a bath.  This would raise the chance of moisture getting near the catheter site, which can result in  infection.     
• Wear a mask over your nose and mouth every time  the catheter is opened to stave off bacteria from entering the catheter and your bloodstream. Specialists changing the dressing should wear a mask and gloves as well.
• The caps and the clamps of your catheter should be kept tightly closed when not being utilized for dialysis. 
• Just your care team should use your dialysis catheter to bring out blood or to give medications or fluids.
• If the region around your catheter feels sore or looks red, contact your dialysis care team at once. Inquire your dialysis team about signs and symptoms that need immediate scrutiny.

Peritoneal dialysis catheter 

Taking good care of the PD catheter and the skin around it (called the exit site  ) is the most crucial way to keep the catheter functioning well, and to lessen the chance of infection.

Just after the  catheter is placed 

• After the catheter is positioned, a sterile gauze bandage is usually bandaged over the exit site to stop the catheter from moving and keep the area clean. 
• For the initial 7 to 10 days, the exit site is usually left alone. After that, the tape is first changed by a PD nurse under sterile conditions. 
• The  catheter should not be moved or touched a lot, due to this there is a  higher chance of infection. 

Subsequently, in the initial first two weeks, the skin around the catheter should not be red or painful. The skin should feel gentle. There may be a small percentage of thick, yellow mucus. A crust or scab may be set every few days.

• While recovering, you should not exercise vigorously or do not do much lifting. The exit site should be entirely healed in 4-6 weeks.
• It is vital to prevent constipation  after the catheter  is positioned . Pushing and stretching to move your bowels can raise the chance of a hernia (a weakness in the belly muscle). Not moving your bowels sufficiently can lead to problems with catheter function (slow drain time or issues with totally draining the belly).
• To prevent or treat constipation, your health care team may approve a high fiber diet along with the exact amount of fluid to assist you to pass stool more effortlessly. They may also instruct for a stool softener or laxative.

Long-Term Care

• Your PD nurse will instruct you about how to maintain your exit site and catheter clean. 

• Maintaining this area clean will lessen the chance of skin infection, as well as an infection inside the belly called peritonitis. If you get peritonitis, it must be dealt with right away. If you get peritonitis several times, or if it lasts for a longer duration, then you may require to stop PD and shift to hemodialysis skin around the exit site should be washed everyday or every other day with antibacterial soap or cleanser approved by your center that does not disturb the skin. 
• The soap should keep up in the same bottle it came in (not poured into another bottle). Bar soap is not suggested because germs can thrive on it.
•  Different types of cleansers, such as hydrogen peroxide or alcohol, should NOT be used unless your healthcare team instructs you to do so.

Guidelines 

• Before cleaning the area, often wash your hands with soap and water and put on neat gloves.
• Hold the catheter in position during cleaning to avoid injury to the skin.
• Do not pick or eliminate crusts or scabs at the exit site.
• Tidy up with antibacterial soap or cleanser. Rinse with clean water or saline.
• After cleaning, softly pat the skin dry around the exit site with a neat cloth or towel. Use the cloth or towel just one  time and never use it on other parts of the body
• Put antibiotic cream on the skin around the catheter with a cotton-tip swab every time  the dressing is shifted. Your center will instruct the type of cream they like you to use. This will prevent infections. 
• Do not use any creams with petroleum because they can harm the catheter.

The exit site should be wrapped with sterile gauze, which should be altered every time the site is cleaned. The catheter should be stuck to the skin with a special tape that permits the skin to get air. Your PD nurse will instruct you on which type to use.

With good exit site care, most PD catheters have no issues and work for many years. If the catheter does not work or is no longer required, it is withdrawn with minor surgery.

What  precautions to  take to keep  my catheter working well?

1. Understand as much as possible about your prescribed treatment plan: your blood flow rate, how frequently and how long you require treatments.
2. Heed the treatment plan
3. Remain for your full treatment time
4. Arrive on or before  few minutes for your hemodialysis medications
5. Inquire your doctor how much dialysis you should be getting. Keep a track  of your Kt/V and URR numbers. 
6. Have a conversation with your dialysis team if your numbers are not as reasonable as they should be.