Dialysis Catheter Melbourne
Dialysis catheters are flexible tubes inserted into a large central vein to provide immediate vascular access for haemodialysis. They are used when urgent dialysis is required before a fistula or graft can mature, or as a temporary measure during access complications. Dr Dias places both tunnelled catheters (designed for weeks to months of use) and temporary non-tunnelled catheters (for short-term emergency access). While catheters have higher infection and complication rates than fistulas or grafts, they provide essential lifesaving access when permanent options are not immediately available.
Written and clinically reviewed by Dr Brendan Dias
Consultant Urologist & Robotic Surgeon · MBBS, MS (General Surgery), DrNB (Urology), IntFRCS (England), FUSANZ, FRACS (Urology)
Last clinically reviewed: 26 August 2026
Benefits
- Immediate dialysis access - can be used straight away
- Essential for urgent or emergency dialysis needs
- Bridge to permanent access while fistula or graft matures
- No needles required for dialysis treatment
- Tunnelled catheters can function for months if well cared for
- Can be placed in various sites (neck, chest, groin)
- Removable when no longer needed
The Procedure
Tunnelled dialysis catheters are typically placed under local anaesthesia with sedation. Using ultrasound guidance, the internal jugular vein in the neck is accessed. A tunnel is created under the skin of the chest, and the catheter is passed through this tunnel before entering the vein. The tunnel and a Dacron cuff help secure the catheter and reduce infection risk. The catheter tip is positioned in the right atrium for optimal flow. The procedure takes 30-60 minutes. Non-tunnelled temporary catheters are placed more simply without tunnelling, usually for short-term use only. X-ray confirms correct positioning.
Who Is a Candidate?
Dialysis catheter insertion is indicated for patients requiring urgent haemodialysis without mature permanent access, as a bridge while awaiting fistula or graft maturation, when permanent access has failed or is being revised, for patients unsuitable for or declining permanent access creation, and for acute kidney injury requiring temporary dialysis. The goal is always to transition to permanent access (fistula or graft) when possible, as catheters carry higher risks with long-term use. Some patients with limited life expectancy or those awaiting imminent transplant may appropriately remain on catheter-based dialysis.
Recovery
Catheter insertion is typically a day procedure. Some neck or chest discomfort is normal for a few days. Keep the exit site clean and dry - follow specific dressing change instructions. Avoid swimming, baths, or submerging the catheter site. Report any signs of infection (fever, redness, discharge, chills during dialysis) immediately. The catheter requires regular flushing with heparin to prevent clotting, typically done at each dialysis session. Handle the catheter carefully to prevent dislodgement or damage.
Risks & Considerations
Dialysis catheter risks include insertion complications (bleeding, pneumothorax, arterial puncture - uncommon with ultrasound guidance), catheter-related bloodstream infection (the most significant risk, 2-5 episodes per 1000 catheter days), catheter thrombosis or malfunction, central vein stenosis with prolonged use (can affect future access options), catheter dislodgement or damage, and exit site infection. Strict aseptic technique during dialysis and good exit site care significantly reduce infection risk. Catheters should be viewed as temporary access with transition to permanent access as the goal.