by admin-blog-kh | July 30, 2025 5:14 am
Dialysis is a life-saving procedure that removes waste, toxins, and excess fluid from the bloodstream, essential for individuals with kidney failure. Introduced in the 1940s, dialysis has since become a critical treatment option. Two main types of dialysis are available: hemodialysis and peritoneal dialysis. For ongoing hemodialysis, permanent catheters provide a stable access point. These catheters are placed in major veins and can be cuffed for long-term use or uncuffed for temporary needs. Permanent catheters are ideal for patients with limited vascular access or who are ineligible for arteriovenous fistulas. However, they come with infection and blood clot risks, requiring diligent hygiene and site care. Despite these challenges, permanent catheters offer essential, efficient dialysis access for many individuals with kidney disease.
Dialysis is a procedure that removes wastes, toxins and excess fluid from the blood[8]. The procedure is performed on patients whose kidneys are failing, to prevent wastes and toxins from building up in the bloodstream. Dialysis was first performed successfully in the 1940s. It has since become the standard treatment for patients with kidney failure.
At present, there are 2 types of dialysis treatments available – Haemodialysis and Peritoneal Dialysis[9]. During haemodialysis, the patient’s blood is tapped off from a vascular access site (usually a vein in the arm), and passed through an external filtering machine called a dialyzer. Think of this machine as an artificial kidney. The blood is purified in the dialyzer and returned to the body through another vascular site. Peritoneal dialysis is a little different. In peritoneal dialysis the blood is filtered while it is still inside the body, using a dialysis solution. The solution is allowed to flow into the peritoneal cavity (where all the abdominal organs are, surrounded by a membrane), where it comes in contact with the blood circulating through the abdomen. The solution dissolves the waste products and after the few hours, the solution can be drained out. In this case, the blood never leaves the body. In this article we will restrict ourselves to discussing haemodialysis.
A permanent haemodialysis catheter is a special IV device that is inserted into a blood vessel in the patient’s arm or neck. Permanent catheters function as a vascular site to connect to the external dialysis machine. For patients who undergo repeated dialysis 3 to 4 times a week, having a permanent catheter is a more comfortable option than repeatedly inserting and removing medical needles. Permanent catheters are also called Permacath.
Cuffed Catheters – This type of catheter is usually recommended for long-term use. They are supposed to stay in place permanently. The cuffed Cather is designed in such a way that the patient’s tissue grows and surrounds the catheter. This eliminates any access points for infection to enter the body.
Uncuffed Catheters – The uncuffed catheter is only meant for short term use, usually up to 3 weeks. This is because, without the cuff for protection, there is a high chance of infection. Uncuffed catheters are often put in place as a temporary measure if the main cuffed catheter is not functional.
Permanent Catheter placement is recommended to patients who undergo dialysis treatment on a regular basis. The patient could be suffering from chronic kidney disease or end-stage renal disease[11]. Patients who have lost kidney function due to cancer or autoimmune disease are also good candidates for Permacath placement.
It is important to note here, that the standard procedure for patients who undergo dialysis often is usually to create an arteriovenous fistula that can be used as a vascular site. This means that the surgeon creates a vascular site, usually in the arm, by joining an artery and a vein. However, in geriatric patients, and patients who are too weak to withstand surgery, a permacath placement is done because its the safer option.
Having a permanent catheter for dialysis makes a lot of sense for patients who need to undergo the treatment regularly. Let’s look at why:
Quick Access – Patients with kidney disease often have to undergo dialysis upto 4 times a week. That’s a lot of cumulative time, and anything that makes the process easier improves the patient’s quality of life. Once the permanent catheter is put in place, dialysis treatment can be done easily, even in case of an emergency.
Less Invasive than AV fistulas – Although AV fistula are the preferred access points for dialysis, in patients who are old or too weak to withstand surgery, a permanent catheter is preferred. It is less invasive and heals well if taken care of.
Effective in the long term – Permanent catheters have been in use for some time now and have proven to be a reliable solution. They are easier to care for, compared to AV fistulas.
Although permanent catheter placement is very useful, it also presents some challenges:
High risk of infection – The catheter is a foreign object placed inside the body. It can serve as an entry point for infections if proper hygiene is not maintained. Tunnel infections or bloodstream infections are potential complications that could occur as a result of an unhygienic Permacath. Old age, diabetes and malnutrition increase the risk of infection.
Blood clot formation – Having a Permacath puts the patient at a higher risk of developing blood clots or thrombosis. Blood clots could form in the catheter itself or the vein. Some patients are prescribed blood thinners to reduce this risk.
Reduced Flow Rate – Permanent catheters generally do not result in a blood flow rate as high as AV fistulas. This means that the blood moves slowly through the dialysis machine, and the procedure takes a longer time to filter the same amount of blood.
Durability – Permacaths are prone to wear and tear. They tend to require replacement every 6 months to a year, unlike AV fistulas.
Lifestyle Limitations – Patients with Permacaths need to be very careful to keep the vascular access point sterile. Patients need to carefully maintain the vascular site everyday, and avoid strenuous activities or excessive sweat. Swimming and other activities that could lead to infection have to be avoided.
Before the catheter is placed, it is important to let the nephrologist know about any medication you are already taking, especially blood thinners. You may need to pause certain medicines for a few days before the procedure. You may also be given a special liquid wash and certain medicines to take before the surgery, to help reduce your chances of infection. It is important to have a consult with the doctor before your procedure and clarify all your questions.
The placement of a Permanent Dialysis Catheter is a minor surgical procedure. The procedure involves creating a “tunnel” under the skin to thread the catheter. This is done using ultrasound or fluoroscopy for accurate placement. The permanent catheter usually has a “cuff” under the skin to keep the catheter in place. The skin will heal around the cuff over time and close any gaps that could let in infections. Permacaths are usually placed in a vein in the neck, non-dominant arm or groin. The patient may experience some mild bleeding and pain after the permanent catheter placement. If you develop heavy bleeding, swelling around the access site or fever, please alert your doctor immediately. It may take up to 3 weeks for the permanent catheter site to heal completely.
Caring for your Permacath makes it last longer and reduces your chances of infection. Here are some tips on how to maintain your vascular site:
Hygiene – Keep the area around the catheter clean at all times. It is important to change the dressings regularly, especially if they become wet. Avoid touching the Catheter, and if you absolutely must then wash your hands first.
Daily Inspection – Observe the catheter site daily for redness, pain, swelling, discharge or any other sign of infection. Get medical help immediately if you notice any of these signs. Also be sure to check your catheter for any signs of mechanical damage, like cracks.
Avoid Strenuous Activity – Avoid exercise, bending, lifting or any activity that could damage the catheter or cause it to become loose.
Flush it regularly – The catheter has to be flushed out after each use. This is usually done by the dialysis nurse, but its a good idea to keep tabs on it anyway. This keeps the catheter clean and functioning smoothly.
Protect from Water – The catheter needs to be protected from water. Do not go swimming or use hot tubs. While bathing, cover the Permacath with a waterproof covering to keep it dry.
According to nephrologists[13], permanent catheters are lifesaving options for patients with kidney disease, especially those who cannot opt for AV fistulas. While they are not without risk, if you follow these tips to care for your catheter, you can be safe.
If you have questions about permanent catheter placement or need expert advice on dialysis care[14], consult the experienced nephrology team at Kauvery Hospital. With branches in Chennai, Hosur, Salem, Tirunelveli, and Trichy, you can rely on their comprehensive support for all your kidney health needs.[15]
What is a permanent dialysis catheter and how is it different from temporary access?
A permanent dialysis catheter, often called a Permacath, is a long-term vascular access placed in a large vein for patients who require ongoing hemodialysis. Unlike temporary catheters, permanent catheters have a cuff to secure them in place and reduce infection risk, making them suitable for regular use.
Who needs a permanent catheter for dialysis?
Patients with chronic kidney disease or end-stage renal disease who undergo regular dialysis may need a permanent catheter—especially if they cannot have an arteriovenous (AV) fistula due to age, weak veins, or other medical conditions.
Is a permanent dialysis catheter safe for long-term use?
Yes, when properly cared for, permanent catheters are safe for long-term use. However, they do carry a higher risk of infection and clotting compared to AV fistulas, so hygiene and monitoring are crucial.
Where is a permanent catheter placed in the body?
Permanent catheters are typically inserted into a central vein, most commonly the jugular (neck), subclavian (chest), or femoral (groin) vein. The choice depends on patient anatomy and doctor recommendation.
How long does a permanent dialysis catheter last?
With proper care, a permanent catheter can last anywhere from 6 months to 1 year or longer. However, regular monitoring is needed to detect any blockages, infections, or wear and tear.
Can you shower or swim with a permanent catheter?
No, swimming is not recommended with a Permacath. During showers, the catheter must be covered with a waterproof dressing to keep the site dry and prevent infections.
How do I care for a permanent dialysis catheter at home?
Keep the site clean and dry, change dressings as instructed, avoid heavy lifting or bending, and check daily for redness, swelling, or discharge. Always follow your nephrologist’s guidelines.
What are the signs of infection in a dialysis catheter?
Watch for fever, chills, pain or swelling at the catheter site, redness, foul-smelling discharge, or warmth around the area. Report these signs to your doctor immediately.
What are the benefits of a permanent catheter for dialysis patients?
Benefits include quicker access to dialysis, less pain from needle pricks, and easier emergency access. It’s also less invasive than surgery for AV fistula, especially in elderly or high-risk patients.
Are there any risks or side effects of using a permanent catheter?
Yes, risks include infections, blood clots, slower blood flow rates, and lifestyle limitations. But with proper care and regular flushing, these risks can be minimized.
Can a permanent catheter be replaced or removed?
Yes, it can be removed or replaced if it becomes blocked, infected, or damaged. Your doctor will guide you on when and how to do this safely.
Is it painful to get a permanent dialysis catheter inserted?
The procedure is done under local anesthesia with ultrasound guidance. You may feel mild discomfort or soreness afterward, but severe pain is rare. Always inform your doctor if pain persists.
Kauvery Hospital is globally known for its multidisciplinary services at all its Centers of Excellence, and for its comprehensive, Avant-Grade technology, especially in diagnostics and remedial care in heart diseases, transplantation, vascular and neurosciences medicine. Located in the heart of Trichy (Tennur, Royal Road and Alexandria Road (Cantonment), Chennai (Alwarpet, Vadapalani & Radial Road), Hosur, Salem, Tirunelveli and Bengaluru, the hospital also renders adult and paediatric trauma care.
Chennai Alwarpet – 044 4000 6000 • Chennai Vadapalani – 044 4000 6000 • Chennai Radial Road – 044 40504050 • Trichy – Cantonment – 0431 4077777 • Trichy – Heartcity – 0431 4077777 • Trichy – Tennur – 0431 4022555 • Maa Kauvery Trichy – 0431 4077777 • Kauvery Cancer Institute, Trichy – 0431 4077777 • Hosur – 04344 272727 • Salem – 0427 2677777 • Tirunelveli – 0462 4006000 • Bengaluru – 080 6801 68011
Source URL: https://www.kauveryhospital.com/blog/nephrology/permanent-catheter-placement-for-dialysis-patients/
Copyright ©2026 Kauvery Blog unless otherwise noted.