Tenchkoff Catheter Placement for Peritoneal Dialysis

Peritoneal dialysis is a way to remove waste products from the blood when the kidneys are no longer functioning adequately, usually in the case of end-stage renal disease. Unlike hemodialysis, which requires patients to come to the hospital for treatment, peritoneal dialysis can be done at home, at work, or even while traveling. During dialysis, the inside of the patient’s abdomen (peritoneal cavity) is filled with a special dialysis fluid. While the fluid is in the peritoneal cavity, extra fluid and waste travel across the peritoneal membrane into the dialysis fluid. After a few hours, the fluid is drained and replaced with new fluid. This process is repeated four to six times a day.

    There are usually few medications involved with peritoneal dialysis and a less restrictive diet. This treatment is not an option for everyone with renal failure, though, as it requires that patients are able to care for the equipment themselves or have a reliable caregiver to do so.

    The Tenckhoff catheter is a flexible plastic tube that is placed in the peritoneal cavity to allow dialysis fluid to be introduced into the abdomen and to drain it once waste products have entered the fluid. The catheter must be placed about two weeks before dialysis is started.

Preparing for the Procedure

The Tenckhoff catheter placement is usually done using general anesthesia so you will need to undergo a health screening as well as blood tests, a chest x-ray, and an EKG to ensure that you are healthy enough for the procedure. Please make sure to let your doctor know about all medication that you are taking as some may need to be stopped before the procedure. You will likely need to avoid all food and water for six to eight hours before the procedure, or as recommended by the doctor.


Placement of the catheter may be done with open surgery or laparoscopically, which involves a few small incisions on the abdomen and tiny surgical tools. The catheter will be inserted through your abdomen and into the peritoneal cavity. It will then be held in place with cuffs. The incisions are closed with dissolvable sutures and the wound on the abdomen will be dressed and covered with a bandage. The portion of the catheter that protrudes from the skin will be taped against your abdomen.

The dressing over the insertion site must not be disturbed for a week or longer. During this time the dressing must be kept dry so showers and baths are to be avoided. The site must heal properly before peritoneal dialysis can be started. You can still perform normal activities as you are comfortable doing so, but avoid lifting heavy objects as well as strenuous activities that can aggravate the area or cause you to sweat in the area.

       When you return to the hospital to have the bandage removed, a doctor or nurse will test the catheter by flushing it with saline. You will then be instructed on how to perform peritoneal dialysis at home independently. How long the catheter remains in place will depend on your condition and your doctor’s treatment plan.

Complications that can occur within 30 days of placement include bowel perforation (<1%), bleeding, and infection. There is also a risk of reaction to anesthesia. Obstruction in the catheter can also occur due to clots, adhesions, or even a kink. Late complications of catheter placement include cuff extrusion or infection, outflow failure, and peritonitis, which is an infection within the peritoneal cavity. There is a strong association between exit-site infections and subsequent peritonitis so early treatment with antibiotics is recommended at the first sign of infection.


The success of the procedure depends on a number of factors. Please discuss the likelihood of success with your doctor before the procedure.


What if the procedure is not performed?

       As mentioned, dialysis is often the final treatment option for patients with end-stage renal disease to keep them alive while they await kidney transplantation. Without dialysis, the patient’s condition will deteriorate, ultimately leading to serious complications and death.

Other than the Tenckhoff catheter, there are other types of catheters that can be used for peritoneal dialysis. Your doctor will determine which the best option for you is. Dialysis is usually the last-resort treatment for end-stage renal disease that is meant to extend the lives of patients until a kidney transplant can be done. While medication can help manage disease to an extent, at some point, medication alone cannot manage the condition.

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