When a patient needs urgent dialysis and has no long-term access (an arteriovenous fistula or graft) ready to use, a catheter-type access is the quick bridge. The two common types are the double-lumen catheter and the tunneled cuffed catheter; they differ in when they are used and in infection risk.
Why is a catheter needed for urgent dialysis?
Long-term accesses such as an arteriovenous fistula (AVF) or graft (AVG) usually need time to mature after creation before they can be used (about 8 weeks to 6 months for an AVF; about 1–4 weeks for an AVG). If a patient needs dialysis right away, a catheter provides a short-term access that is quickly available, bridging the period until the long-term access is ready.
What is a double-lumen catheter?
A double-lumen catheter provides a quickly available, short-term dialysis access for patients who need urgent dialysis. This type of catheter has no cuff, so the chance of infection is higher, and removal as early as possible is usually recommended to reduce related complications.
What is a tunneled cuffed catheter?
A tunneled cuffed catheter (also called a PERcath, TCC or Hickman catheter) provides short- to medium-term dialysis access. Its cuff design lowers the chance of infection, but it is still advisable to complete a long-term dialysis access as soon as possible and remove the catheter early to reduce related complications.
| Item | Double-lumen catheter | Tunneled cuffed catheter |
|---|---|---|
| When used | Urgent, very short term | Short- to mid-term |
| Cuff | None | Yes |
| Infection risk | Higher | Lower (but still higher than a long-term access) |
| Recommended approach | Remove as early as possible | Remove after converting to a long-term access as soon as possible |
General points for all catheter-type accesses
Whichever type is used, a catheter is a transitional, short-term access. Several options (such as an arteriovenous fistula or graft) can reduce how long a patient depends on a catheter and thereby lower related complications. Patients are encouraged to discuss with a vascular surgeon how to complete a long-term access promptly so that the catheter can be removed early.
Frequently Asked Questions
Q: How long can a catheter be used?
A: A catheter is a short- or short-to-medium-term transitional access. The actual duration depends on the individual case; in principle, converting to a long-term access and removing the catheter early is recommended.
Q: Is a catheter more painful?
A: Catheter placement is an invasive procedure performed with local anaesthesia. How it feels varies from person to person; please discuss the details with your care team.
Q: Why should the catheter be removed early?
A: The longer a catheter stays in place, the higher the risk of infection and other complications, so it is advisable to complete a long-term access and remove the catheter as soon as possible.
Plan the long-term access early
A catheter is an important bridge for urgent dialysis, but it is not a long-term solution. Discussing a fistula or graft with a vascular surgery team early helps lower infection risk and improve the quality of dialysis. If you have related needs, you are welcome to contact the Hemodialysis Access Care team.
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