Removal of dialysis line

This leaflet has been written to give you information about having your tunnelled haemodialysis line removed.

Why is the line being removed?

There are many reasons for removing a haemodialysis line. These can include:

• your fistula has been successfully needled on four to six occasions in a row
• infection of your line
• your line is blocked and is no longer working
• your line is no longer needed
• successful kidney transplant

Your kidney doctor or nurse will give you an appointment to attend as an outpatient to have your line removed.

Where will the line be removed and is there any special preparation?

Haemodialysis lines are normally removed in vascular access unit level four by one of the kidney doctors who will be assisted by a dialysis nurse. The line will be removed under local anaesthetic so you will stay awake and the procedure normally takes about 20 to 30 minutes.

If you take warfarin medication to thin your blood it may need to be stopped before your line is removed to prevent bleeding. A special blood test will be taken to check that your blood is clotting properly before the procedure. If you take clopidogrel, you should check with your kidney doctor whether this needs to be stopped before your line is removed. You can drink normally before the procedure and have a light meal.

How is the line removed?

As the haemodialysis line is tunnelled under the skin the line will be gently released. The skin around the area will be cleaned and a small amount of local anaesthetic injected into the area to make it numb (so it does not hurt). The injection will sting a little but will soon make the skin become numb. The doctor will then be able to make a small cut in your skin. This will allow the doctor to loosen the line from under the skin. You may feel a little bit of pressure. When the line has been loosened it should come out easily. The doctor will remove the line whilst you are breathing out and may ask you to hold your breath.

The doctor and nurse will explain exactly what they want you to do during the procedure. As the line is removed, gentle pressure will be applied over the entry point for about five minutes. Two or three stitches are normally put into the skin and a dressing is placed over the cut. If there is bleeding after the procedure, you may be asked to remain on the bed for a time and have your blood pressure and pulse taken. If there is no bleeding and your blood pressure and pulse are stable, you will be able to go home.

What should I look out for after my line has been removed?

You will need to check for:

Bleeding – it is normal for there to be a small amount of bleeding onto the dressing. However if the dressing becomes full of blood contact your nurse or doctor and apply pressure over the dressing if necessary. For out of hours, contact your GP or the telephone number provided below

Soreness – when the local anaesthetic wears off you may experience some discomfort. Take your normal pain relief tablets as advised (paracetamol for example) to take away the discomfort.

Swelling – it is normal for there to be slight swelling around the area. If the swelling is getting bigger please contact your dialysis nurse or doctor. You should only take shallow baths to avoid ‘dirty’ water and reduce the risks of getting an infection. Showering with clean flowing water is preferred until the stitches have been removed. If the dressing becomes wet then it should be replaced. Once the stitches have been removed you can bathe normally and there will be no need to have a dressing.

When will the stitches come out?

When you go home you will need to keep your dressing clean and dry. The stitches should be removed after 10 to 14 days. If you are on dialysis then one of the nurses should be able to remove the stitches when you come to the unit. Otherwise you will need to book an appointment with the practice nurse at your GP surgery.

Contacts/ Further information

Addenbrooke’s dialysis unit 01223 400181

Hinchingbrook dialysis unit 01223 400181

West Suffolk dialysis unit 01284712921

Queen Elizabeth Kings Lynn dialysis unit 01553 613544

Privacy & dignity

Same sex bays and bathrooms are offered in all wards except critical care and theatre recovery areas where the use of high-tech equipment and/or specialist one-to-one care is required.