Hemodialysis Catheter-related Infection: Prophylaxis, Diagnosis and Treatment

Böhlke, Maristela; Uliano, Gustavo; Barcellos, Franklin Corrêa

doi:10.5301/jva.5000368

Cited by 65 publications

(80 citation statements)

References 71 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Close monitoring and management of comorbid disease is essential for risk reduction in these patients [7,9]. The most common causes of death in our study included cardiac and infectious diseases, which is consistent with the current literature [16,17,18,19]. In addition, metabolic/endocrine disorders and vascular diseases were also a significant cause of mortality in this study [20].…”

Section: Discussionsupporting

confidence: 79%

Mortality after Renal Allograft Failure and Return to Dialysis

Brar

Markell²,

Stefanov³

et al. 2017

Am J Nephrol

View full text Add to dashboard Cite

Introduction: The outcomes of patients who fail their kidney transplant and return to dialysis (RTD) has not been investigated in a nationally representative sample. We hypothesized that variations in management of transplant chronic kidney disease stage 5 leading to kidney allograft failure (KAF) and RTD, such as access, nutrition, timing of dialysis, and anemia management predict long-term survival. Methods: We used an incident cohort of patients from the United States Renal Data System who initiated hemodialysis between January 1, 2003 and December 31, 2008, after KAF. We used Cox regression analysis for statistical associations, with mortality as the primary outcome. Results: We identified 5,077 RTD patients and followed them for a mean of 30.9 ± 22.6 months. Adjusting for all possible confounders at the time of RTD, the adjusted hazards ratio (AHR) for death was increased with lack of arteriovenous fistula at initiation of dialysis (AHR 1.22, 95% CI 1.02-1.46, p = 0.03), albumin <3.5 g/dL (AHR 1.33, 95% CI 1.18-1.49, p = 0.0001), and being underweight (AHR 1.30, 95% CI 1.07-1.58, p = 0.006). Hemoglobin <10 g/dL (AHR 0.96, 95% CI 0.86-1.06, p = 0.46), type of insurance, and zip code-based median household income were not associated with higher mortality. Glomerular filtration rate <10 mL/min/1.73 m² at time of dialysis initiation (AHR 0.83, 95% CI 0.75-0.93, p = 0.001) was associated with reduction in mortality. Conclusions: Excess mortality risk observed in patients starting dialysis after KAF is multifactorial, including nutritional issues and vascular access. Adequate preparation of patients with failing kidney transplants prior to resuming dialysis may improve outcomes.

show abstract

Section: Discussionsupporting

confidence: 79%

Mortality after Renal Allograft Failure and Return to Dialysis

Brar

Markell²,

Stefanov³

et al. 2017

Am J Nephrol

View full text Add to dashboard Cite

show abstract

“…[22][23][24] CVC dysfunction was identified as consistently suboptimal blood flow of <250 mL/min and/ or declining dialysis performance. 18 A standard X-ray was used to exclude catheter displacement and kinking. 5,25,26 We collected data on complications at each HD session and adverse outcomes in relationship to the respective techniques.…”

Section: Definitions Of Complications and Adverse Outcomesmentioning

confidence: 99%

“…With this in mind, they expressed an urgent need to clinically assess the pertinence and safety of the standard techniques and connection materials. 18 As part of an EBP strategy, the present study aimed to assess and compare the safety performance and other potential complications of a Y-connection and the usual tunneled CVC connection to the HD machine for blood restitution. In a second phase, we explored HD patients' preferences and frontline HD nurses' opinions on the ease of use and safety of both techniques.…”

mentioning

confidence: 99%

Point prevalence of complications between the Y connection technique and the usual care technique for blood restitution in patients of an outpatient hemodialysis unit: a comparison

Tacchini-Jacquier¹,

Verloo²

2017

IJNRD

View full text Add to dashboard Cite

Background: Central venous catheter-related infections (CVCIs) in patients on maintenance hemodialysis (HD) have been documented due to unsafe/unsterile manipulations by nurses during HD machine deconnection and reconnection. Given the gravity of CVCIs in HD patients using catheter access, precise, safe installation of the device, and good nursing technique are crucial. Aim: To assess and compare safety performance and complications of a Y-connection (n=133) versus the usual tunneled central venous catheter (CVC) technique (n=73) among HD patients and then explore preferences between techniques among patients and frontline HD nurses. Materials and methods: A prospective, comparative, 3-month point prevalence survey was conducted among HD outpatients and frontline HD nurses in a 600-bed teaching hospital in the canton of Valais. Results: Nine HD outpatients (average age, 68.3 years; SD=12.3) were recruited. The two techniques showed no differences in C-reactive protein levels (p=0.465), pain (p=1.00), or local complications due to dressings soiled by exudate at the catheter insert point (p=0.066). The relative risk ratio (RR) indicated that CVCI was 1.667 times (95% CI; 0. 437, 6.358, p=0.50 (RR 0.58; [95% CI; 0.277, 1.217]; p=0.13) were significant relative risk factors for complications. Fifty-seven percent of HD patients stated that they felt more secure and comfortable using the Y-connection technique than the usual care technique. Eleven of the 12 nurses involved preferred the Y-connection technique, feeling that is was safer and easier in use. Conclusion: No difference was found in the complication rates of two blood restitution techniques -the Y-connection versus the usual CVC technique. HD outpatients and nurses preferred the Y-connection for blood restitution.

show abstract

“…[13][14][15][16][17][18] Despite these efforts, the use of CVCs for HD continues to be a leading contributor to higher rates of BSI, hospitalization, morbidity, and mortality, as well as increased health care costs. 19,20 Aims and Objectives 1.…”

mentioning

confidence: 99%

Study of Central Venous Catheter Related Blood Stream Infections in Patients on Haemodialysis

Pankaj¹,

Sinha²,

Das³

et al. 2018

jebmh

View full text Add to dashboard Cite

BACKGROUNDTemporary and permanent central venous catheters are used in majority of patients of CKD when initiated on hemodialysis and mostly these catheters act as bridge before permanent AV fistula assess could be obtained. Blood stream infections related to these central venous catheters are an important cause of morbidity and mortality in these patients. Appropriate antiseptic precautions while inserting central venous catheter and early identification of catheter related blood stream infections (CRBSI) are of utmost importance for reducing hospital stay, cost of therapy and mortality.

show abstract

Hemodialysis Catheter-related Infection: Prophylaxis, Diagnosis and Treatment

Abstract: The best approach to prevent CVC-related infection would be to avoid the use of CVC. However, in patients for whom it is impossible, the adoption of adequate prophylaxis protocols, early diagnosis and effective treatment of infectious complications are essential to improve outcomes.

Cited by 65 publications

References 71 publications

Mortality after Renal Allograft Failure and Return to Dialysis

Mortality after Renal Allograft Failure and Return to Dialysis

Point prevalence of complications between the Y connection technique and the usual care technique for blood restitution in patients of an outpatient hemodialysis unit: a comparison

Study of Central Venous Catheter Related Blood Stream Infections in Patients on Haemodialysis

Contact Info

Product

Resources

About