Comparison of clinical characteristics and outcomes of infective endocarditis between haemodialysis and non-haemodialysis patients in China

Abstract

Objective To clarify differences in clinical characteristics and outcomes between patients with infective endocarditis (IE) receiving long-term haemodialysis (HD group) and those not receiving haemodialysis (non-HD group). Methods Medical records of patients with IE, admitted to hospital between January 2010 and December 2017, were retrospectively studied. Clinical characteristics and outcomes were compared between HD and non-HD groups. Risk factors for IE were assessed by COX regression. Results Twenty-one HD and 143 non-HD patients were included. Predisposing heart conditions were more frequently observed in the non-HD versus HD group (90.9% versus 19.0%). Inappropriate antibiotic therapy rate before admission and proportion of methicillin-resistant Staphylococcus aureus and Enterococcus-associated IE was higher in the HD versus non-HD group. In the HD group, fewer patients underwent heart surgery (9.5% versus 51.7%), all-cause in-hospital mortality was higher (52.4% versus 21%), and survival rate was lower versus the non-HD group. COX regression analysis revealed that haemodialysis, use of central venous catheter (CVC) and inappropriate antibiotic therapy before admission increased IE mortality, while surgery improved long-term prognosis. Conclusions Haemodialysis patients with IE may have higher mortality and lower survival rates than patients with IE not receiving haemodialysis. Haemodialysis, use of CVC and inappropriate antibiotic therapy before admission may increase IE mortality. Surgery may improve long-term prognosis.

Comparative analysis of infective endocarditis in hemodialysis versus non-hemodialysis patients in Iran: implications for clinical practice and future research

“…In the present study, the mean ages of HD and non-HD patients were not significantly different, which is in line with studies by Bentata et al, Kwon et al, Hsiao et al, and Zhang et al, who have not noted any statistically significant age difference between the groups [ 20 , 23 , 24 , 26 ]. In contrast, Stahl et al and Bhatia et al reported significantly lower mean ages in the hemodialysis group [ 8 , 25 ].…”

“…Gender differences are reported heterogeneously in other studies. Pericas et al and Kwon et al found predominantly female hemodialysis IE patients, whereas Bentata et al, Stahl et al, and Zhang et al noted mostly males in both groups [ 19 , 20 , 23 – 25 ]. This may be due to regional differences in the cohorts.…”

“…Despite the well-established increased burden of infective endocarditis (IE) in hemodialysis (HD) patients, many knowledge gaps remain regarding optimal prevention and treatment approaches for this vulnerable group. Mortality rates have persistently remained high, ranging from 29.5 to 45.6% in recent studies, indicating that current management strategies are inadequate [ 5 , 18 – 20 ]. Further research is critically required to clarify best practices and improve the poor prognosis of IE in HD patients.…”

Etiological Structure of Infective Endocarditis in Certain Categories of Patients (Literature Review)

“…Представители Candida встречаются крайне редко. Вместе с тем, отмечается относительно высокая частота отрицательных посевов крови, что чаще всего связывают с предшествующим применением антибактериальных препаратов, значительно осложняющим лечение пациентов в дальнейшем [32].…”

Impact of unplanned peritoneal dialysis start on patients' outcomes—A multicenter cohort study

“…In urgent cases, unplanned dialysis start is the only option to save patients with ESKD. Individuals who start unplanned dialysis are more likely to be treated with hemodialysis (HD) using a central venous catheter (CVC) ( 3 ), which has been associated with a greater infection rate and other early complications, as well as a higher risk of long-term bad outcomes ( 4 – 6 ). Over the past decade, several authors have described their center's experiences with unplanned PD and the term “urgent-start” PD has emerged ( 7 , 8 ).…”