A Tenckhoff catheter is a medical device used to drain or filter fluid in the abdomen, and is commonly used in the treatment of chronic kidney failure and various cancers of the kidney. It is a thin, flexible tube that surgeons implant into the region just outside of the kidney to drain buildups and help to help circulate and spread blood filtering fluids and other medications. These catheters can be either temporary or permanent, and are usually one of the least intensive treatment options for many patients. The devices require a lot of care and precision, but in most cases the effort is less than it would be with a standard dialysis machine or other comparable treatment.
The main goal of this sort of catheter, as is the case with almost any catheter, is to simplify access to some internal body cavity. It is very effective at draining fluid that has accumulated around the kidney, often known as ascites, and it is also frequently used for internal blood filtering. The catheter usually has a small valve the protrudes from the skin, and patients adjust the settings in order to instruct the device’s function. Opening a drainage valve can force fluids out of the body, for instance, while attaching medications or filtering fluids can pump things in. Most of the time these tasks can be done by the patient on his or her own once the catheter has been installed and the incision site has healed.
Differences From Standard Dialysis
Kidney failure patients often prefer Tenckhoff catheters to standard dialysis, which tends to be more invasive. The procedures have similar goals, though. The human kidneys filter the body’s blood of impurities and waste, and problems can cause backlogs of toxins that can be life threatening. Most types of standard dialysis replace some of the kidney’s functions by removing waste and other fluids from the patient’s blood with an artificial membrane located within the dialysis machine. The patient’s blood is pumped through the machine, filtered, and then put back into the body’s circulation.
Tenckhoff-style catheters perform what is known as “peritoneal dialysis.” This does not require that the patient’s blood be pumped outside of his body, but rather it’s cleaned while still inside. The organs in the abdomen are surrounded by an area called the peritoneum, which is a membrane that allows waste products to pass through it. Peritoneal dialysis runs dialysis fluid, a sugar solution with some salts, into the abdominal cavity. This allows the patient’s blood to be filtered without pumping it through a dialysis machine.
How It’s Set Up
Surgeons install or place the catheters with a series of targeted incisions. Patients usually have to stay overnight in the hospital during placement, but sometimes the procedure can be done on an outpatient basis. The majority of the catheter is inside the body, and the only evidence on the outside is the end valve, which usually extends outside of the body by about four inches (approximately 10 cm). The portion that protrudes is usually secured with a surgical stitch that will ultimately heal and become a more or less permanent part of the abdominal wall, and patients typically need to wait about two weeks after the procedure to begin actually using the catheter to be sure things have healed and the body has adjusted.
People who need constant dialysis often find this sort of catheter more convenient since it allows them to do a lot of their filtration at home, thus saving trips to dialysis clinics. It also tends to be less costly overall, and can get better results for people who need treatment on a permanent basis. The device can also be useful for more limited windows, though the process of surgically removing the catheter can be painful.
Care and Cleaning
The easy access that the catheter gives to the inner abdomen means that patients often have to be really careful to care for themselves in order to prevent infection. The valve usually must be cleaned and disinfected regularly, and it must usually be covered while showering, bathing, or otherwise coming into contact with water. Many healthcare professionals discourage catheter patients from swimming, particularly in open waters that could introduce bacteria or other contaminants to the entry point. People who have the device on a long-term basis also usually need to have it checked or inspected once a year or so to be sure that it is continuing to hold up.
Risks and Common Problems
Peritoneal dialysis and draining from the catheter tend to be very effective for most people, but the process must be monitored carefully to avoid problems. Leaks from the Tenckhoff catheter during dialysis are common, for instance, and infections of the insertion site may also occur and must be treated immediately. After a number of years patients may also experience a thickening of the peritoneum, which can cause the dialysis to stop functioning correctly. If peritoneal dialysis cannot consistently be completed the patient’s physician may suggest other types of dialysis.