Catheter, hemodialysis/peritoneal, long-term
HCPCS code
Name of the Procedure:
Common Name(s): Long-term Catheter for Dialysis
Technical/Medical Term: Hemodialysis/Peritoneal Catheter (HCPCS C1750)
Summary
A long-term dialysis catheter is a thin, flexible tube inserted into a large vein (for hemodialysis) or into the abdominal cavity (for peritoneal dialysis). It is used for kidney dialysis in patients with chronic kidney disease to help filter and clean their blood when their kidneys are no longer able to perform this function effectively.
Purpose
Medical Conditions Addressed:
- Chronic Kidney Disease (CKD)
- End-Stage Renal Disease (ESRD)
Goals:
- To facilitate regular dialysis treatments
- To manage and maintain adequate waste removal and fluid balance in patients whose kidneys are not functioning properly
Indications
- Patients with severe kidney failure requiring long-term dialysis
- Inadequate kidney function not managed well with other treatments
- Patients awaiting kidney transplant
Preparation
- Fasting may be required if general anesthesia is used.
- Blood tests to check kidney function, electrolyte levels, and overall health.
- Possibly imaging studies (ultrasound, X-ray) for catheter placement guidance.
- Adjustment of current medications as per physician's instructions.
Procedure Description
- Insertion Site Preparation: The insertion site (chest for hemodialysis, abdomen for peritoneal dialysis) will be disinfected.
- Anesthesia: Local anesthesia and possibly sedation are administered. General anesthesia may be used in some cases.
- Incision: A small incision is made at the designated site.
- Catheter Placement: The catheter is carefully guided and positioned into the large vein or abdominal cavity.
- Securing the Catheter: Sutures or adhesive materials hold the catheter in place.
- Testing: The catheter is tested to ensure proper function and flow.
- Dressing: The insertion site is dressed to prevent infection.
Tools/Equipment Used:
- Catheter (sterile)
- Ultrasound or fluoroscopy for guidance (if needed)
- Sterile surgical instruments
- Dressing and securing materials
Duration
The procedure typically takes about 30 minutes to 1 hour.
Setting
- Hospital (Outpatient/Day Surgery Unit)
- Outpatient Clinic
- Surgical Center
Personnel
- Vascular Surgeon or Nephrologist
- Surgical Nurses
- Anesthesiologist (if general anesthesia is used)
Risks and Complications
Common Risks:
- Infection at the insertion site
- Bleeding or hematoma
Rare Risks:
- Catheter malfunction or displacement
- Injury to surrounding tissues or organs
- Blood clots
Management of Complications:
- Antibiotics for infections
- Minor surgical adjustments for catheter repositioning or malfunction
Benefits
- Effective management of kidney failure
- Maintenance of fluid and electrolyte balance
- Symptom relief and improved quality of life
When Benefits are Realized:
- Immediate benefits post-procedure with proper catheter function
Recovery
- Post-procedure monitoring for a few hours
- Keep the insertion site clean and dry
- Follow-up appointments for catheter care and dialysis sessions
- Avoid heavy lifting and strenuous activities for the first few days
Recovery Time:
- Initial recovery within a few days, with full adjustment over a couple of weeks
Alternatives
- Arteriovenous (AV) Fistula or AV Graft for hemodialysis
- Conservative management with medications and diet adjustments
- Kidney transplant
Pros and Cons of Alternatives:
- AV Fistula/Graft: Longer lasting but requires time to mature
- Conservative Management: Non-invasive but may not be sufficient for advanced disease stages
- Kidney Transplant: Permanent solution but requires donor match and carries surgical risks
Patient Experience
During Procedure:
- Mild discomfort or pressure at the insertion site
- Sedation or anesthesia ensures minimal pain
After Procedure:
- Soreness at the insertion site, managed with pain medications
- Instructions on site care and signs of infection to watch for
- Regular dialysis sessions as per treatment plan
Effective communication with the healthcare team and proper care post-procedure are crucial for successful treatment and recovery.