Catheter Infection Among Hemodialysis Patients: A Report From Fars Province, Iran

Abstract

BackgroundEnd-stage renal disease (ESRD) is currently a major global public health issue, particularly among old age populations (1,2). Available data shows that the incidence of ESRD has an increasing trend in both developing and developed regions of the world (1).In addition, ESRD patients should undergo regular hemodialysis through a vascular access. Three main types of vascular access are now available including central venous catheters, synthetic arteriovenous grafts, and arteriovenous fistulas (3).Central venous catheters are not always the best choice although they are yet used as frequent vascular access for hemodialysis (4). The complications of these catheters can be categorized into infectious and non-infectious groups (4). Catheter dysfunction, central vein stenosis, and catheter-related thrombi are among the non-infectious complications of hemodialysis catheters (4). Further, catheter-related bloodstream infection (CRBI) is the main infectious complication of hemodialysis catheters. The term CRBI is used to describe bacteremia that originate from an intravenous catheter (5). CRBI, as the most frequent complication of central venous catheters, is known as a major cause of nosocomial bacteremia as well (4-6). It is evident that the use of central venous catheters increases all causes of mortality among hemodialysis patients. This is particularly due to CRBI (7). Previous research has shown that patients with ESRD with a tunneled central venous catheter for hemodialysis are at about 15-fold increased risk of CRBI in comparison with those who use arterio-venous fistula for this purpose (6).The above-mentioned facts emphasize the importance of planning and policy-making regarding prevention, timely diagnosis, and treatment of catheter-related complications, specifically CRBI in order to reduce the burden of these issues for patients and the health-care system. To this end, it is essential to collect local data on the prevalence, risk factors, and outcomes of hemodialysis patients with catheter-related complications, which was the aim of the current research.

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

“…According to the findings of this study, gender does not predict CRI. Shirotani et al, Coker et al, and Mohammadkarimi et al's studies also documented no relationship between gender and CRI (19,20).…”