How to avoid catheter-related infections in hemodialysis and dialysis peritoneal patients

Thinking of our patients we have created a simple guide for better understanding
the catheter usage and so, avoid needless complications caused by infections.

Let's remember that catheters and their location depend on the type of dialysis we
are currently using.

When the type is Hemodialysis the catheter is located at subclavian level in the
thoracic cavity, preferably at the jugular vein, with a two-way catheter used one
artherial and other venous. The blood leaves the body trough the first way by the
extracorporeal circuit and returns trough the second with the blood already filtered.
For the peritoneal dialysis the catheter is located at abdominal level passing throught
the skin, subcutaneous tissue and the peritoneum.

Why are catheter-related infections so common?

As nurse Patricia Rodríguez, Baxter Renal Care Services nephrology specialist for
22 years, most of these infections are generated by external handling as the
catheter being a foreign body to the organism. Nevertheless, she points out cases 
where the infection is produced internally (endogenous) but insists that most of
the times the origin is external. 

"As far as we are concerned as a health team is to worry some more about the infection
from exogenous ways, especially what is related to the handling. For the hemodialysis
catheter case there are two options: being handled by the patient themselves or being
handled by the medical team.  The latter implies guides and handling protocols with
asceptic technique, which means wearing sterile gloves, sterile gauze, disinfectant
solutions, facial mask as well as leaving the catheter covered and teaching selfcare
and accident prevention measures to the patient", explains Rodríguez.
Simple recommendations to avoid infections.

• Do not allow personal other than the renal unit handling your catheter. This must be
handled by trained personnel only and it's exclusively used in your dialysis.

• At bathing time cover the catheter area in order to avoid moisture which favours the
infection.

• Do not handle the catheter nor remove the dressing untill the renal clinic performs the
required healing.

• Avoid pools, rivers or bathtubs. Catheter must not ever be under water.

Alarm signs

In order to know if there is infection the patient must watching signs and symptoms
indicated by their doctor or nurse, such as fever, shortness of breath, chills, thoracic
pain or catheter dettaching.  

The gauze tissue must never be wet or bleeding and the stitches should look
healthy and not loose. The zone must not show any redness, pain or heath sensation.
If that were the case the patient must immediately go to their doctor and nurse from the
renal unit.

Lastly, Rodríguez highlisghts that the most important measure is hygiene.
"hands washing habit is nowadays relevant for every kind of infection." Remember,
vascular access is the life of a dialysis patient.