Journal
AMERICAN JOURNAL OF KIDNEY DISEASES
Volume 52, Issue 5, Pages 982-993Publisher
W B SAUNDERS CO-ELSEVIER INC
DOI: 10.1053/j.ajkd.2008.06.014
Keywords
Hemodialysis; vascular access; bacteremia; catheter-related infections; arteriovenous fistula
Categories
Funding
- Canadian Patient Safety Institute
- KRESCENT
- Fonds de la Recherche en Sante du Quebec
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Hemodialysis is associated with a high risk of morbidity and mortality, often caused by infections. Infections account for approximately 15% of all deaths in this patient population (the second leading cause after cardiovascular events) and for about one-fifth of admissions. Approximately one-fourth of infection-related admissions are caused by dialysis-associated peritonitis or vascular access infection that may lead to such significant complications as endocarditis or death. Published studies that assessed the determinants of hemodialysis-related vascular infections reported inconsistent findings. Variations in the definitions of infection among these studies despite the existence of standard guidelines proposed by at least 3 major work groups may explain, at least in part, these inconsistencies. A comprehensive in-depth review of those studies is needed to examine the inconsistencies in the published results. We first revised the existing vascular access-related infection definitions, then conducted a narrative review of the published literature that examined predictors of vascular access-related infections, highlighting the heterogeneity in methods and findings. Better understanding of the risk factors for vascular access-related infections may inform efficacious prevention strategies and lead to early detection of infections and improved patient care. Am J Kidney Dis 52:982-993. (C) 2008 by the National Kidney Foundation, Inc.
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