Tunnelled dialysis line insertion

Category: Kidney & Dialysis Procedures · All kidney & dialysis procedures

What it is

A tunnelled dialysis line is a soft tube placed into a large vein in the neck (sometimes groin) with its tip in the big vein near the heart. Part of the tube runs under the skin ('tunnelled') with a cuff that anchors it and reduces infection risk. It allows dialysis to start straight away.

Why it is done

It is used when dialysis is needed urgently before a fistula exists, while a fistula matures, or when other access options are not suitable.

How to prepare

You will have blood tests and a review of medicines (especially blood thinners). The insertion is usually done in a procedure room or theatre with local anaesthetic and sometimes sedation; you may need to fast if sedation is planned.

What happens during the procedure

Using ultrasound, the doctor numbs the skin, guides the tube into the vein, tunnels it under the skin to an exit site on the chest, and checks position with an X-ray. It takes about 30 to 60 minutes. The line is stitched or dressed securely.

Afterwards — recovery & results

You can usually have dialysis the same day. The line must be kept dry and its dressings changed only by trained staff or trained patients; never let anyone use it for other purposes. Report fever, redness, pain, or the line slipping out immediately — infection of the line can become serious quickly.

Risks & considerations

Risks include bleeding, infection (the main long-term risk), clotting of the line or vein, narrowing of the central veins over time, and malposition needing adjustment. For these reasons a fistula remains the goal for most long-term patients.

Frequently asked questions

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