Nephrostomy Catheter

What problems can occur with a nephrostomy catheter?
The main problem that can occur is infection. You can have two types of infection, one of which is more serious than the other. The first and less serious infection is a skin infection. This can occur around the skin in your back where the catheter has been inserted. If this occurs in spite of good skin care, it is usually simple to treat. The more serious infection can occur in your kidney. This usually happens if the catheter gets blocked. The best way to avoid this is to have your catheter changed for a new one regularly. Your doctor and the interventional radiologist will help to schedule you for a catheter change. If your catheter gets blocked and your kidney gets infected in spite of good care, your doctors can treat the problem by changing your catheter and giving you antibiotics.

What do I do for proper skin care around my nephrostomy catheter?
Because your catheter is on your back, you will need help.

  1. Keep the skin around your nephrostomy catheter dry. You can take a shower, but cover the area with plastic wrap. Tape the edges of the plastic wrap to your skin so that water cannot get under it. If the area should get wet, dry the skin completely after your shower.
  2. Keep the skin around your nephrostomy catheter clean. Clean the area every day to every other day with a cotton swab that has bee moistened with peroxide. Always wash your hands before you clean the catheter site.
  3. Keep the skin around your nephrostomy catheter covered. After you have cleaned the skin at the catheter insertion site, cover the area with a clean bandage or dressing. Change the dressing if it gets wet.

What are the signs of a skin infection and what should I do for it?
The signs are redness, soreness, and sometimes swelling of the skin around the catheter. If you notice any of these, follow these instructions unless your doctor specifies otherwise:

  1. Clean the skin site more often. If you did it once a day, do it twice a day. If you did it every other day, do it every day.
  2. Use antibiotic ointment on the skin around the catheter after each time you clean it.

If these symptoms do not improve within 48 hours, or if they worsen, call your doctor. If your symptoms do improve promptly, continue with your extra care for one week, and then go back to your usual care routine.

How can I keep my nephrostomy catheter from getting blocked so I won't get an infection?
The possibility that your nephrostomy catheter will get blocked cannot always be completely avoided. Below is a list of instructions which can minimize the risk:

  1. If your nephrostomy catheter drains urine into an external drainage bag, rinse the bag out with water every day. It is best to have two bags so that you can wear one while rinsing the other.
  2. In most cases, your catheter should be changed every 2-3 months. Keep your appointment. Changing the catheter helps to prevent catheter blockage. It is much easier to change the catheter out for a new one than it was to place the original catheter. This is usually done as an outpatient.

What are the signs that my nephrostomy catheter is blocked or that I have a kidney infection?
These two problems frequently go together. Signs that your catheter is blocked are back pain and leakage of urine around the catheter site into your skin and dressing. Kidney infection signs are pain, fever and chills.

Who do I contact if I think I have a kidney infection or think that my catheter is blocked?
Call the interventional radiologist and/or your primary doctor immediately. These doctors will arrange for prompt treatment of your condition. In most cases, you will need an antibiotic and your catheter changed. You may also need to be admitted to the hospital. If your tube has been capped off or turned off to external drainage, uncap it and connect it to an external drainage bag.

What supplies do I need to take care of my nephrostomy tube?
You will need to buy: cotton swabs or cotton balls, hydrogen peroxide, gauze pads, surgical tape, antibiotic ointment, drainage bags. You can purchase these things at drug stores or hospital supply stores. You will be informed if you need any additional supplies.

How active can I be with my nephrostomy catheter?
When the catheter is first put in, you will be sore for 1-2 weeks. This will limit your activity. After that, you should continue to avoid any activity that may cause a pulling sensation or pain around the catheter. You also want to avoid any kinking of the catheter.

Are there any other reasons I should contact doctor about my catheter?
Yes, and these are the reasons:

  1. Your catheter becomes broken or dislodged.
  2. You have stitches and they become loose.
  3. Your catheter begins to leak.
  4. There is blood around or in your catheter.

Which doctor do I call about my nephrostomy catheter care?
Your catheter was placed by a specially trained doctor called an interventional radiologist. This doctor works with your other doctors to take care of you once you have a nephrostomy catheter. Your team of doctors may prefer that you contact the interventional radiologist directly if you have a problem relating to your catheter. Or, your doctors may prefer that you contact your surgeon, internist or family doctor first. Ask your doctors whom you should call when you need help or advice with catheter care.


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