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What is a Tenckhoff Catheter?

P.S. Jones
P.S. Jones

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.

Main Function

A Tenckhoff catheter is thin and flexible.
A Tenckhoff catheter is thin and flexible.

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

Tenckhoff catheters are normally used for peritoneal dialysis.
Tenckhoff catheters are normally used for peritoneal 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.

A Tenckhoff catheter is commonly used in the treatment of chronic kidney failure and kidney cancer.
A Tenckhoff catheter is commonly used in the treatment of chronic kidney failure and kidney cancer.

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

Placement of a Tenckhoff catheter may require an overnight hospital stay.
Placement of a Tenckhoff catheter may require an overnight hospital stay.

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.

A Tenckhoff catheter is a device commonly used in the treatment of chronic kidney failure.
A Tenckhoff catheter is a device commonly used in the treatment of chronic kidney failure.

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.

Discussion Comments

anon280139

Can the tenckhoff catheter be used for a j-tube also?

FirstViolin

A Tenckhoff peritoneal catheter can be used in two different ways for peritoneal dialysis treatment: Continuous Ambulatory Peritoneal Dialysis (CAPD), and Continuous Cycler-Assisted Peritoneal Dialysis (CCPD).

The first process, CAPD, requires the patient to drain the bags into the abdomen at certain scheduled intervals. This treatment is good for people who are ambulatory and are willing and able to keep up with the strict schedule required.

The second process, CCPD, uses an automatic cycler to disperse the fluids into the abdomen. This can be really helpful for those who don't want to fool with a schedule of dispersal times, or for those who are unable to perform the dispersals without help.

CCPD even works overnight, so patients don't have to worry about ever being without their dosage.

pharmchick78

Did you know that the scarring of the abdoment hat comes with a Tenckhoff catheter insertion can actually help hold the catheter in place?

That's why many doctors tell patients that there is a breaking in period for their catheter. It's not like with shoes, that you have to break the shoes in -- it's breaking your body in, and getting it ready for the process.

Of course, this can make Tenckhoff catheter removal a little tricky sometimes, especially in the case of infection, but usually everything comes out just fine.

LittleMan

What a great advance in medicine -- I bet that kidney failure patients were so happy when the Tenckhoff catheter came along so they didn't have to go to a dialysis clinic so much.

It sounds like it's just such a convenient thing -- but I think I'd be a little apprehensive putting my own dialysis fluid in, at least the first few times!

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    • A Tenckhoff catheter is thin and flexible.
      By: Aleksandrs Jermakovi
      A Tenckhoff catheter is thin and flexible.
    • Tenckhoff catheters are normally used for peritoneal dialysis.
      By: picsfive
      Tenckhoff catheters are normally used for peritoneal dialysis.
    • A Tenckhoff catheter is commonly used in the treatment of chronic kidney failure and kidney cancer.
      By: nerthuz
      A Tenckhoff catheter is commonly used in the treatment of chronic kidney failure and kidney cancer.
    • Placement of a Tenckhoff catheter may require an overnight hospital stay.
      By: vichie81
      Placement of a Tenckhoff catheter may require an overnight hospital stay.
    • A Tenckhoff catheter is a device commonly used in the treatment of chronic kidney failure.
      By: snapgalleria
      A Tenckhoff catheter is a device commonly used in the treatment of chronic kidney failure.