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Tunnelled Haemodialysis Line (CENTRAL VENOUS CATHETER)

Introduction

This webpage tells you about having a haemodialysis line (central venous catheter) inserted for haemodialysis treatment. Please read it as well as talking to your doctor/nurse.

What is a tunnelled haemodialysis line (CENTRAL VENOUS CATHETER) insertion?

A tunnelled haemodialysis line is a soft plastic tube that is placed into a large vein. It allows your blood to be taken to the dialysis machine and returned to you during haemodialysis.

• The line usually goes into a vein in the neck (most common)
• Sometimes it goes into the groin (top of the thigh)
• Part of the line sits under the skin (“tunnelled”), which helps reduce infection risk and keeps it more secure

Once in place, the line can be connected to the dialysis machine when you need dialysis.

Why might I need a dialysis line

You may need a dialysis line if your kidneys are not working well enough to remove extra fluid and waste products from your blood.

Dialysis can help relieve symptoms and prevent serious complications such as:

• breathlessness from fluid overload
• dangerously high potassium
• severe sickness or confusion
• heart rhythm problems

Sometimes the line is inserted urgently so dialysis can start quickly.

Where is it done?

The line is usually inserted:

• in a procedure room on the ward, operating theatre, or X-ray department

It usually takes less than 30 minutes.

Most people have it done with local anaesthetic, meaning:

• you are awake
• the area is numbed
• you can usually eat and drink normally before and after (unless your team advises otherwise)

How is the line inserted (step- by - step)

1. You lie on your back. The bed may be tilted slightly.
2. The skin is cleaned with antiseptic.
3. Local anaesthetic is injected (this can sting briefly).
4. The doctor uses ultrasound to find the vein.
5. A needle is placed into the vein, and a thin wire is passed through it.
6. The line is then threaded into place over the wire.
7. The wire is removed.
8. The line is secured with a stitch and a dressing.

If the vein is difficult to access, the line may need to be inserted in the X-ray department using X-ray guidance.

What happens afterwards?

• You may feel some pressure during the procedure, but it should not be painful.
• If the line is placed in the neck, you will usually have a chest X-ray afterwards to confirm position and check there is no lung problem.
• When the anaesthetic wears off, you may have mild bruising or soreness around the area for a short time.

 At home after insertion

• Avoid strenuous exercise for a few days.
• Some units advise not to shower or bathe, but instead having a strip wash ask your kidney team about this as you be able to shower, but the dressing must stay clean and dry  and they can advise of the local policy and waterproof dressings

Get urgent help if you have:

• heavy bleeding that doesn’t stop
• severe pain at the line site
• swelling in the neck/face/arm on the line side
• breathlessness or chest pain
• fever, shivering, redness, swelling, or pus around the line

If bleeding occurs press firmly over the area with a clean towel and seek help immediately.

What are the risks?

Serious complications are uncommon, but it’s important you understand them.

Possible risks include:

• Bleeding or bruising
• Damage to a nearby artery
• Puncture of the lung (pneumothorax) (mainly with neck lines)
• Irregular heartbeat during insertion (usually brief; you are monitored)
• Infection of the line or bloodstream
• Rarely, needing a blood transfusion or further procedure

Using ultrasound and/or X-ray guidance reduces many of these risks.

Important: tell your team before the procedure if you:

• bruise or bleed easily
• take blood-thinning medicines (e.g., warfarin, apixaban, rivaroxaban, dabigatran, aspirin, clopidogrel)
• have allergies (especially to antiseptics such as iodine/chlorhexidine).

What are the benefits ?

A dialysis line allows dialysis to start promptly. Dialysis can:

• remove fluid and waste products
• improve symptoms
• reduce the risk of serious complications from kidney failure

 Are there alternatives? 

A line is often used as a temporary access to start haemodialysis.

Longer-term options include:

• an arteriovenous fistula (AVF) (a connection between an artery and vein in the arm)
• sometimes an arteriovenous graft (AVG)
• peritoneal dialysis, which uses a tube in the tummy (available in some centres and situations)

If you decide not to have dialysis, your team will discuss other supportive treatments, but these usually cannot replace dialysis in severe kidney failure.

Looking after your haemodialysis catheter HDC

Daily checks

1. Keep both clamps always closed. Never open them.
2. Make sure the bungs/caps at the end of each line are in place and tight. Check especially after dressing/undressing or washing.
3. Keep the dressing clean, dry, and stuck down. Your dialysis nurse will clean the exit site at dialysis.
4. Protect the line — do not use scissors, pins, or sharp objects near it.
5. Always wash hands before touching the line. Anyone handling the catheter should use sterile gloves and sterile gauze.
6. Do not allow blood tests or medication through the catheter unless it’s an emergency or the renal team has agreed.

If something goes wrong at home 

1) A clamp is open

• Wash hands and close it firmly so it pinches the line shut.
• If you cannot close it, phone the renal unit straight away.
• Tell the dialysis nurse at your next session even if you manage to close it.

2) A bung/cap is missing

• Wash hands and replace with a spare from your pack if you have one.
• Phone the renal unit straight away — you may need review and/or antibiotics.

3) Dressing has come loose or fallen off

• Wash hands and apply a new dressing if you have one.
• Contact the renal unit if you cannot keep it clean and dry.

4) Split, crack, or leak in the line

• Clamp the line if possible and phone the renal unit immediately.
• You may need to come in urgently.

5) Signs of infection

Phone the renal unit urgently if you have:

• fever, shivering, feeling “fluey”
• redness, swelling, tenderness, or discharge at the exit site

Last reviewed January 2026
Next review January 2029

Reviewed by Dr. Jyoti Baharani

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The National Kidney Federation cannot accept responsibility for information provided. The above is for guidance only. Patients are advised to seek further information from their own doctor.