Aim and objectives: In hemodialysis patients, catheter-related bloodstream infections (CRBSI) cause significant morbidity and mortality. We analyzed CRBSI incidence, associated factors, and the causative organisms’ spectrum. Methodology: Patients aged ≥18 years either on maintenance hemodialysis or with acute kidney injury having CRBSI (NKF-KDOQI criteria) were included in this prospective observational study and patients with other infections were excluded. Blood, catheter tip culture and antibiogram were analyzed. All patients were initially treated with antibiotics covering both gram-positive and gram-negative pathogens. Results: Of 921 catheters (882 patients) analyzed, 212 (23%) had CRBSI, of which 69(32.5%) and 143(67.5%) had possible CRBSI and probable CRBSI respectively. 131 (61.8%) were <60 years, 133 (62.7%) were males, 177 (83.5%) had diabetes, 141(66.5%) had leukocytosis and 172(81.1%) had positive procalcitonin. 193 (91%) had uncuffed catheters and 162 (76.4%) had jugular catheters. Our study showed that CRBSI incidence was 13.39/1000 catheter days, median catheter days, and median time to CRBSI was 40 and 17.2 days. Gram-positive coagulase-negative staphylococcus aureus (n=31; 44.9%) followed by extended-spectrum beta-lactamase (ESBL) enteric gram-negative organisms (n=30; 43.4%) were common isolates and remaining had fungal etiology (n=8; 11.7%). Conclusion: The incidence of CRBSI was high in our population. In culture-positive cases, gram-positive organisms contributed marginally higher than gram-negative organisms. Coagulase Negative Staphylococcus aureus (CONS) and ESBL enteric gram-negative organisms are the commonest isolates. More than two-thirds of patients with CRBSI had diabetes mellitus and leukocytosis at presentation.

Objectives To find the prevalence of knowledge of arteriovenous fistula (AVF) self-care, its characteristics, and associated factors among hemodialysis patients and summarize the findings of various domains of AVF self-care in south Asian countries. Methods The systematic literature search was performed on online databases and additional sources to retrieve published articles on AVF self-care. We estimated the pooled prevalence using a random effects model in meta-analysis. Additionally, thematic knowledge regarding various aspects of AVF self-care was narratively summarized. Results Among the articles retrieved seven studies met our inclusion and exclusion criteria. The prevalence of AVF self-care in individual studies ranged from 59% to 99%, with an overall random pooled prevalence of 81% (95% CI, 68% to 94%). Major factors associated with self-care of AVF knowledge included patients’ educational status, age, vintage of hemodialysis, and healthcare personnel’s advice. Discussion Knowledge scarcity regarding potential measures of AVF self-care obligates the need for continuous education in hemodialysis patients. A multidisciplinary approach is vital to enhance self-care from pre- to post-creation of AVF in hemodialysis patients as well as their caregivers in order to prolong the patency rates and decrease the subsequent morbidity and mortality due to failure of AVF.

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Aim: In transplantation, accurate donor glomerular filtration rate (GFR) estimation is crucial. While various creatinine based equations are in use, none are validated in Indians, thus this study was conducted to judge accuracy of creatinine based GFR estimation equations and urinary creatinine clearance. Methods: A single-centre, observational and retrospective study at a tertiary care hospital. Adult voluntary donors GFR measured (mGFR) by Tc‑99m DTPA were included. Primary outcome was performance of estimated GFR (eGFR) by Cockcroft-Gault's formula corrected for body surface area (CG-BSA), Modification of diet in renal disease (MDRD) 4/6 and Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI); Secondary outcome was performance of 24 hour urinary creatinine clearance (Cr Cl). Results: 102 kidney donors were analysed with mean age of 45.89 ± 9.98 years and 85.3% females. Mean ± SD mGFR by Tc‑99m DTPA was 82.11 ± 14.32 ml/min/1.73m2. Mean ± SD eGFR (ml/min/1.73m2) by CG-BSA was 99.68 ± 23.71, by MDRD-4 was 98.25 ± 28.61, by MDRD-6 was 93.66 ± 19.44 and by CKD-EPI was 111.14 ± 31.61. Lowest bias (2.3), highest precision (16.23) and accuracy (97.1%) was with MDRD-6; 24-hour urinary Cr Cl highly overestimated GFR (158.27 ml/min/1.73 m2) with highest bias, lowest precision and accuracy. Conclusion: Among the equations, MDRD-6 was the most precise and accurate with 24 hour urinary creatinine clearance being the least reliable. This study highlights the need for a correction factor or a new GFR estimation equation and not to consider urinary Cr Cl to assess donor GFR.

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