Potential Risks for and Prognoses After Infections and Antimicrobial use Among Hemodialysis Outpatients: A Prospective Study

Abstract

Background: The aims of this study were to determine the prevalence and characteristics of infections as well as the use of antimicrobials among hemodialysis outpatients. Methods: We used the dialysis event surveillance protocol to conduct a prospective study in 2019. Results: Totally 180 outpatients who received maintenance hemodialysis were included in the cohort study. The total number of dialysis events was 53 in 38 patients. Among the collected events, 42 (79.25%) events used intravenous antimicrobial treatments; five (9.43%) had positive blood cultures; and six (11.32%) had pus, redness, or swelling at the access site. Type of vascular access was an influencing factor for infection among hemodialysis outpatients. Blood flow rate on dialysis was another factor influencing infection events, the risk of infection increased in patients who had lower blood flow rate. Additional analysis showed that lower blood flow rate was also observed as adverse impact in patients who used central lines, but not in those with fistulas. And Erythropoietin use was higher in the infection group. Conclusions: Patients who used central lines, and especially patients both with central lines and low blood flow rate, were more vulnerable to infection. Using Erythropoietin was another risk factor for infection in hemodialysis outpatients.