If your kidney disease has progressed quickly, you may not have time to get a long-lasting vascular access before starting hemodialysis. In this case, you may require a venous catheter–a small, soft tube inserted into a vein in your neck, chest, or leg near the groin–as a temporary access. A nephrologist or an interventional radiologist–a doctor who uses medical imaging equipment to perform operations–performs the placement of the venous catheter in a hospital or an outpatient clinic. You will receive local anesthesia and sedation to keep you calm and relaxed during your procedure.

The catheter splits in two after the tube exits your body. The two tubes have caps designed to connect to the arterial line, which carries your blood to the dialyzer, and the venous line, which carries blood from the dialyzer back to your body. Clamps on the tubes can be closed if one of the lines is disconnected.

Although not encouraged, some people use a venous catheter for long–term access. When a person needs a venous catheter for more than 3 weeks, the vascular surgeon will “tunnel” the catheter under the skin, rather than insert it directly into the vein. A person will be more comfortable and have fewer complications with a tunneled catheter than with a nontunneled catheter.