scholarly journals Causes and Risk Factors of Hemodialysis Catheter Infection in Dialysis Patients: A Prospective Study

2021 ◽  
Vol In Press (In Press) ◽  
Author(s):  
Ebrahim Nasiri ◽  
Mohammad Hossein Rafiei ◽  
Yusef Mortazavi ◽  
Pouya Tayebi ◽  
Mehdi Ghasemzadeh Bariki
Keyword(s):  
Risk Factors ◽  
Systemic Infection ◽  
Venous Catheter ◽  
Hemodialysis Patients ◽  
Cross Sectional ◽  
Hemodialysis Catheter ◽  
Catheter Infection ◽  
Post Surgery ◽  
Hospitalization Costs ◽  
Catheter Site

Objectives: Infectious central venous catheter (CVC) complications, including mortality and care and hospitalization costs, are still a major clinical concern. This study aimed to determine the prevalence of hemodialysis catheter infection and its risk factors among hemodialysis patients. Methods: The present research was a descriptive, prospective cross-sectional study on hemodialysis patients in Babol hospitals during 2020 - 21. The participants' demographic information and some relevant data on clinical variables (namely underlying diseases, cause of dialysis, and cause of catheter removal) and catheter-related variables (namely catheter location, frequency of catheter placement, and apparent signs of catheter site) were collected and recorded directly and systematically during surgery post-surgery. Results: One hundred and twenty-two patients with temporary double-lumen acute hemodialysis catheters for dialysis, including 56 women (45.9%), were included in this study, the mean age of whom was 58.9 ± 16.4 years. Twenty-two patients (18%) developed a catheter-induced systemic infection. There was no significant relationship between the catheter site and its removal inducing infection (P > 0.05). The frequencies of microorganisms causing catheter infection included gram-positive Staphylococcus epidermis (59%) and Staphylococcus aureus (31.8%). Moreover, there was no significant correlation between demographic variables and clinical history with systemic infection induced by catheterization. Conclusions: The rate of catheter-induced infection is relatively high among patients since sterile instructions were observed during catheterization; therefore, it is recommended to pay more attention to the care and dressing of the catheter site.

Antibiotic Treatment of Chronic Central Venous Hemodialysis Catheter inFection without Catheter Removal

1987 ◽  
Vol 10 (4) ◽  
pp. 239-240 ◽  
Author(s):  
D.T. Domoto ◽  
D.J. Kennedy
Keyword(s):  
Central Venous Catheter ◽  
Proteus Mirabilis ◽  
Hemodialysis Patient ◽  
Venous Catheter ◽  
Hemodialysis Patients ◽  
Central Venous ◽  
Hemodialysis Catheter ◽  
Catheter Infection ◽  
Continued Use ◽  
Shunt Infections

Most catheter or shunt infections in hemodialysis patients require the removal of the access before the infection is eradicated. A hemodialysis patient is reported who had multiple previous vascular accesses which failed and thus who had very limited sites for future access placement. When a recurrent Proteus mirabilis catheter infection occurred, a 6-week course of ampicillin intraluminal and tobramycin systematically, eradicated the infection and thus the central venous catheter was salvaged. Serum bactericidal levels with these two antibiotics were obtained early in the course and supported the continued use of antibiotics alone to treat the infection.

Evaluation of the Fibromyalgia and Related Risk Factors in Patients with Advanced Kidney Failure Undergoing Hemodialysis

2021 ◽  
Vol 17 ◽  
Author(s):  
Seyed Mostafa Seyedmardani ◽  
Saeed Abkhiz ◽  
Azadeh Megrazi ◽  
Aarefeh Jafarzade ◽  
Golshan Kamali Zonouz
Keyword(s):  
Risk Factors ◽  
Kidney Failure ◽  
Fibromyalgia Syndrome ◽  
Cross Sectional Study ◽  
Hemodialysis Patients ◽  
Cross Sectional ◽  
Age And Gender ◽  
Significant Difference ◽  
Symptom Severity Score ◽  
And Gender

Background : Fibromyalgia syndrome (FMS) is defined as widespread and persistent pain in the musculoskeletal system. There are limited reports regarding the prevalence of fibromyalgia syndrome in patients with advanced kidney failure undergoing regular hemodialysis. Therefore, this study aimed to evaluate the prevalence of fibromyalgia syndrome and its risk factors in a large proportion of patients under the hemodialysis condition. Materials and Methods: In this cross-sectional study, 293 patients who were admitted to the hemodialysis ward were evaluated for fibromyalgia syndrome in an educational hospital. The questionnaire was designed according to symptom severity score (SS score) and widespread pain index (WPI) criteria. The correlation between FMS and various variables, including demographic, clinical, and biochemistry biomarkers, was also precisely calculated by logistic regression. Data were analyzed using SPSS v.17 statistics software. Results: The results showed that, of 293 hemodialysis patients, 130 patients (44.4%) had fibromyalgia, the mean age of patients with and without fibromyalgia was 61.09 ± 15.36 and 53.49 ± 15.38 years old, respectively (P = 0.001). Moreover, there was a significant difference in terms of gender among patients with fibromyalgia syndrome (P = 0.001). To note, there was no significant relationship between the kidney failure etiopathogenesis, duration of dialysis, body mass index (BMI), Kt/v index, history of peritoneal dialysis, and laboratory parameters with fibromyalgia in hemodialysis patients (P > 0.05). However, our findings revealed that both age and gender could be considered as the predictor variables associated with fibromyalgia in patients undergoing hemodialysis. Conclusion: Taken together, in this study, we found that age and gender would be the critical factors in terms of the fibromyalgia syndrome in patients undergoing hemodialysis.

scholarly journals Hemodialysis Catheter-Related Infection in a Teaching Hospital of Central Nepal

2019 ◽  
Vol 41 (2) ◽  
pp. 11-16
Author(s):  
Arun Sedhain ◽  
Abja Sapkota ◽  
Narayan B Mahotra
Keyword(s):  
Risk Factors ◽  
Blood Stream Infection ◽  
Antibiotic Sensitivity ◽  
Major Complication ◽  
Venous Catheter ◽  
Blood Stream ◽  
Recent Change ◽  
Catheter Related Infection ◽  
Hemodialysis Catheter ◽  
A Prospective Study

Introduction: Infection of the central venous catheter (CVC) is a major complication seen among patients undergoing hemodialysis. Identifying CVC related infection (CRI) and its risk factors and causative organisms is important for better implementation of preventive strategies. Methods: A prospective study was conducted at Chitwan Medical College for duration of 2 years from January 2017to December 2018 among the patients undergoing hemodialysis via CVC. The data collected were related to patients’ demographics, site of catheter insertion, and duration, microbiological data including cultures from catheter sites, blood, and catheters’ tips and antibiotic sensitivity. Catheter related infection was divided into catheter related local infection (CRLI) and catheter related blood stream infection (CRBSI). Data was analyzed using IBM SPSS Statistics version 21.0. Results: A total of 41 cases of CVC related infection (CRI) were documented with an incidence rate of 6.94 episodes per 1000 catheter days at risk. Out of the total CRI, 39.02% were CRLI and 60.98% were CRBSI. Fever with chills and rigor were the most common clinical presentation. Risk factors for the development of CRI were duration of catheter in situ, repeated change of CVC and the use of CVC for indications other than hemodialysis (HD).Staphylococci and Klebsiella were the most common organisms isolated in culture. Conclusion: The rate of CRI among Nepalese patients undergoing hemodialysis is high. Prolonged duration of CVC usage, recent change of catheter and the use of the HD catheter for the purpose of institution of intravenous medication have been found as the risk factors for CRI.

scholarly journals Risk factors and costs of household perspectives in hemodialysis patients on Hospital Of Bhayangkara Tk. I. R. Said Sukanto

2020 ◽  
Vol 14 (1) ◽  
Author(s):  
Anggelina Aprilia Pangalila ◽  
Prih Sarnianto ◽  
Shirly Kumala
Keyword(s):  
Risk Factors ◽  
Cost Analysis ◽  
Control Method ◽  
Hemodialysis Patients ◽  
Primary Data ◽  
Cross Sectional ◽  
Western Herbs ◽  
The Cost ◽  
The Impact ◽  
Structured Questionnaire

The incidence and prevalence of chronic kidney disease (CKD) patients in Indonesia is increasing every year. In the promotion of health promotion and prevention efforts, data related to risk factors and cost analysis are needed from the perspective of patients and / or families related to CKD treatment that requires replacement therapy for kidney function (Hemodialysis / HD). CKD patients undergo HD therapy generally twice a week, making it a relatively large burden on them. This study aims to determine the risk factors for CKD in hemodialysis patients at Bhayangkara Hospital Tk. I R. Said Sukanto and the impact of the cost of HD therapy from a household perspective. In an observational study with this case control method. Primary data was taken through interviews using a structured questionnaire with 100 HD patients (cases) and 100 patients from other poly (control), cross sectional. Risk factor analysis was carried out by logistic regression (p <0.05) and cost analysis using the accounting method. The results showed that in terms of socio-demography, ages above 40-49 years had a risk of 32.7 times and ≥ 50 years had a risk of 17.9 times having CKD compared to <30 years of age with an education level ≤ SD-SMA at risk 16.9 times affected by CKD from the academy / university group, and the income of Rp. 2,000,000 - Rp. 4,000,000 has a risk of 8.4 times being affected by CKD from income groups> Rp. 6,000,000. In terms of biophysiology, hypertension, diabetes and anemia had a risk of 516 times, 54 times and 272 times the effect of CKD. The habit of consuming Chinese and Western herbs increases the risk of developing CKD up to 10.9 times. The cost of the household perspective issued by the patient includes a meal cost of Rp360,000, transportation costs Rp.320,000 and drugs and multivitamins Rp250,000. The potential loss of productivity reaches Rp1,241,904 per patient per month.

scholarly journals Risk factors for cardiovascular hospitalization in hemodialysis patients

Medicina ◽  
2010 ◽  
Vol 46 (8) ◽  
pp. 544 ◽  
Author(s):  
Rūta Vaičiūnienė ◽  
Vytautas Kuzminskis ◽  
Edita Žiginskienė ◽  
Kristina Petrulienė
Keyword(s):  
Risk Factors ◽  
At Risk ◽  
Cox Regression ◽  
Cohort Analysis ◽  
Hemodialysis Patients ◽  
Hemoglobin Level ◽  
Cross Sectional ◽  
Cox Regression Analysis ◽  
Disability Status ◽  
The Mean

The aim of this study was to evaluate the risk factors for cardiovascular hospitalization in hemodialysis patients. Materials and methods. A cross-sectional cohort analysis of risk factors during one census month (November) and one-year follow-up for cardiovascular hospitalization rates during 5 consecutive years (2002–2006) in all end-stage renal disease patients hemodialyzed in Kaunas region was carried out. During the census month, we collected data on patient’s age and sex, disability status, comorbidities, anemia control, malnutrition and inflammation, calciumphosphorus metabolism, and patient’s compliance with prescribed medications. We analyzed 559 patients during 1163 patient-years of observation. Patients were considered as new patients every year (1520 cases). Kaplan-Meier method and Cox regression analysis were used to evaluate time to first hospitalization. Results. The mean number of cardiovascular hospitalizations was 0.31 per patient-year at risk, the total days of cardiovascular hospitalizations per patient-year at risk were 3.93, and the mean length of one hospitalization was 13.2±12.9 days. Cardiovascular diseases were the most frequent cause of hospitalization (25% of all hospitalizations). The relative risk of cardiovascular hospitalization increased by 1.03 for every year of age, by 1.7 for worse disability status, by 1.4 for nonadherence to medications, by 1.1 for every additional medication prescribed to the patient. Cardiovascular hospitalization risk was decreased by 0.99 with a 1-g/L rise in hemoglobin level. Conclusions. Older age, worse disability status, patient’s noncompliance with medications, and higher number of medications used were associated with a higher risk for cardiovascular hospitalization. Higher hemoglobin level was associated with a lower risk for cardiovascular hospitalization.

Risk factors for diminished bone mineral density among male hemodialysis patients—a cross-sectional study

2012 ◽  
Vol 7 (1-2) ◽  
pp. 283-290 ◽  
Author(s):  
Sasan Mirfakhraee ◽  
Khashayar Sakhaee ◽  
Joseph Zerwekh ◽  
Beverley Adams-Huet ◽  
Ugis Gruntmanis
Keyword(s):  
Risk Factors ◽  
Bone Mineral Density ◽  
Bone Mineral ◽  
Cross Sectional Study ◽  
Hemodialysis Patients ◽  
Sectional Study ◽  
Mineral Density ◽  
Cross Sectional

scholarly journals Risk Factors for Low Humoral Response to BNT-162b2 In Hemodialysis Patients

2021 ◽  
Author(s):  
Rui Duarte ◽  
Cátia Figueiredo ◽  
Ivan Luz ◽  
Francisco Ferrer ◽  
Hernâni Gonçalves ◽  
...  
Keyword(s):  
Risk Factors ◽  
High Risk ◽  
Humoral Response ◽  
Venous Catheter ◽  
Hemodialysis Patients ◽  
Older Age ◽  
Maintenance Hemodialysis ◽  
List Type ◽  
Central Venous ◽  
Dialysis Vintage

AbstractIntroductionMaintenance Hemodialysis (HD) patients are at higher risk of both infection and mortality associated with the new coronavirus 2. Immunization through large-scale vaccination is the cornerstone of infection prevention in this population. This study aims to identify risk factors for low response to the BNT-162b2 (Pfizer BioNTech) vaccine in a HD cohort.Materials and MethodsObservational prospective study of a HD group followed in a Portuguese Public Founded Hemodialysis Center who received BNT-162b2 vaccination. Specific anti-Spike IgG was evaluated as arbitrary units per milliliter (AU/mL) on two separate occasions: 3 weeks after the first dose and 3 weeks after the second. IgG titers, Non-Responders (NR), and Weak-Responders (WR) after each dose were evaluated against risk factors that included demographic, clinical and analytical variables.ResultsHumoral response evaluated by IgG anti-Spike levels showed a strong correlation with Charlson comorbidity index (CCI) and intact parathormone (iPTH) after each inoculation (1st dose: ρ=−0.64/0.54; 2nd dose: ρ=−0.66/0.63, respectively; p<0.01 throughout). After completing both doses: 1) NR were associated with female sex (p<0.01), lower albumin and iPTH (p=0.01); 2) WR showed higher CCI, older age, lower iPTH and lower albumin (p=<0.01, p=0.03, p<0.01, p=0.05, respectively) and, consistently, associated with CCI over 8, age over 75, iPTH under 150 ng/L, female sex, dialysis vintage under 24 months and central venous catheter (CVC) over arteriovenous fistula (p=0.01, p=0.03, p<0.01, p=0.01, p=0.01, p<0.01, respectively). A binary regression model using CCI, sex (male) and CVC was statistically significant in prediction of WR after the 2nd dose with OR (95% CI): 1.81 (1.06-3.08); 0.05 (0.01-0.65); 13.55 (1.06-174.18), respectively (p=0.01).ConclusionOlder age, higher CCI, lower iPTH and albumin, CVC as vascular access and recent hemodialysis initiation (less than 2 years) associate with lower response to vaccination in our study. A higher comorbidity burden is suggested as a more significant surrogate marker for low immunogenicity rather than age alone. Identifying HD patients as a population at high-risk for low response to vaccination is essential for proper policy-making, facilitating the implementation of adequate and individualized contingency protocols.What is already known about this subjectMaintenance hemodialysis patients have lower humoral response to BNT-162b2 COVID-19 vaccine when compared to the general population.Maintenance dialysis patients are at high risk of exposure to coronavirus 2 in addition to a more severe disease course.What this study addsWe suggest Charlson commorbidity index, older age, intact parathormone, central venous catheter as vascular access and lower dialysis vintage as possible surrogate markers of immunogenicity in HD patients.There is a low humoral response after a single dose of the vaccine (50%) that can be increased after the second (86%).What impact this may have on practice or policyStrict Protocols for follow-up measures in HD patients, including closer humoral titers assessment, risk stratification, adequate isolation, and surveillance of symptoms might be necessary in order to improve this population survival/life expectancy.Screening HD patients, seroconversion rates may be improved by giving extra inoculations for patients at risk for low response.

scholarly journals Risk factors for central venous catheter related bloodstream infection: a multicenter study of intensive care unit and haemodialysis unit

2019 ◽  
Vol 47 (1) ◽  
pp. 18-21
Author(s):  
Zeenat Afroz ◽  
Mohammad Jobayer ◽  
Md Ferdous Mian ◽  
Farook Ahamed ◽  
Mizanur Rahman ◽  
...  
Keyword(s):  
Risk Factors ◽  
Central Venous Catheter ◽  
Femoral Vein ◽  
Venous Catheter ◽  
Blood Stream ◽  
Cross Sectional Study ◽  
Central Venous ◽  
College Hospital ◽  
Cross Sectional ◽  
Factors Affecting

The clinical condition of the patient, type of central venous catheter (CVC), site and duration of CVC placement are the factors affecting the risk of infection. The aim of this study was to examine and find out the risk factors of CVC related blood stream infections (CVC-BSI). This cross sectional study was carried out in the Department of Microbiology and Immunology of Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh during the period of July 2011 to June 2012. One hundred patients who were admitted in ICU of BSMMU and ICU and haemodialysis unit of Dhaka Medical College Hospital (DMCH) having central venous catheter, were enrolled in the study. The rate of CVC-BSI was 11% and the incidence was observed to be 11.14/1000 catheter days. Both CVC-BSI and CVC colonization were higher in trilumen than in bilumen central venous catheter. CVC-BSI rate was 12.79% in trilumen whereas there was no CVC-BSI in patient with bilumen catheter. The mean duration from CVC insertion to development of CVC-BSI was 14 days, CVC colonization was 8.41 days and noninfected CVC was 6 days. CVC-BSI and CVC colonization were most common in right femoral vein where CVC-BSI was 18.52% and CVC colonization was 59.26%, whereas no CVC-BSI was found in right internal jugular vein. Risk factors for CVC-BSI included type of CVC, site of CVC placement, duration of catheterization were not found statistically significant in this study. CVC-BSI and CVC colonization were higher in trilumen catheter and rate raised with increased duration of placement and highest number of CVC-BSI and colonization was found in right femoral vein. Bangladesh Med J. 2018 Jan; 47 (1): 18-21

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