Relation between Access‐Related Infection and Preinfection Serum Albumin Concentration in Patients on Chronic Hemodialysis

Adeniyi, Oladipo; Tzamaloukas, Antonios H.

doi:10.1046/j.1492-7535.2003.00054.x

Cited by 12 publications

(7 citation statements)

References 32 publications

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“…Infections are also known to be more frequent and severe in dialysis patients than in the general population. [8][9][10][11][12]23,[26][27][28] Most studies found that the Hemodialysis International 2010; 14:S14-S21 S18 use of temporary or permanent HD catheters carries clear clinical disadvantages. High frequency and severity of pneumonias in HD populations have been found in a National registry study.…”

Section: Discussionmentioning

confidence: 99%

“…A substantial fraction of the hospitalizations and mortality is also caused by vascular access complications. [8][9][10][11][12] There are substantial differences between countries in mortality and hospitalization rates of patients on HD. Although there are other potential interpretations for these differences, one of the interpretations suggests that at least some deaths of HD patients during hospitalization may be preventable.…”

Section: Introductionmentioning

confidence: 99%

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Death during hospitalization in patients on chronic hemodialysis

Behl

Sun

Agaba

et al. 2010

Hemodialysis International

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Mortality from various causes is higher in patients on chronic hemodialysis (HD) than in the general population. There is evidence suggesting that some of the deaths in HD patients are preventable. To identify potentially preventable causes of death, we analyzed deaths that occurred in HD patients during hospitalization over a period of 15 years. We performed a retrospective cohort analysis of 410 patients on HD for at least 6 months between 1995 and 2009 (included), who had all their hospitalizations in the same hospital. The patients were classified into 3 groups: Those who died during hospitalization (group A, n=120), those who died away from the hospital (group B, n=135), and those who were alive at the end of the observation period (group C, n=155). Continuous variables were compared between groups by the Kruskall-Wallis statistic. Logistic regression was used to identify predictors of dying during the observation period and predictors of death in the hospital. For the whole HD group of 410 patients, only 9 (2.2%) were women. 59% of the patients had diabetes mellitus. Age at the onset of HD was 65.8 ± 11.5 years and the duration of HD was 34.4 ± 27.9 months. Group A patients had a higher annual rate and duration of hospitalization and a higher Charlson comorbidity index than either of the other 2 groups, and, in comparison with patients in group C, were older at the end of observation and had a shorter duration of HD. Cardiac disease (19.2%), vascular access complications (18.3%), peripheral vascular disease (16.7%), infections (15.8%), trauma (11.7%), central nervous system disease (7.5%), respiratory failure (4.2%), malignancy (3.3%), and gastrointestinal disease (3.3%) were the causes of the last hospitalization in group A. Compared with the patients who died during hospitalization without discontinuing HD, group A patients who discontinued HD had a longer duration of their last hospitalization (52.7 ± 77.7 vs. 14.3 ± 23.8 days, P<0.001). Discontinuation of HD occurred in 80% of the hospitalizations for respiratory failure, 75% of the hospitalizations for malignancy, 57% of the hospitalizations for trauma, and 56% of the hospitalizations for central nervous system disease. Logistic regression identified a high Charlson index, advanced age, and short duration of HD as predictors of death, and an absence of diabetes, high Charlson index, prolonged annual duration of hospitalization, and short distance of the patient's domicile from the dialysis unit as predictors of death in the hospital. A substantial number of hospitalizations leading to the death of HD patients are caused by potentially preventable conditions, including vascular access complications, peripheral vascular disease, and trauma. Implementation of measures preventing these hospitalizations is a worthwhile undertaking.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Death during hospitalization in patients on chronic hemodialysis

Behl

Sun

Agaba

et al. 2010

Hemodialysis International

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“…A sizable proportion of subjects in our study were hypertensive and had low albumin levels perhaps suffering from malnutrition. 38,39 Hypoalbuminemia (<3.5) has been reported to be a risk factor for recurrent bacteraemia. 40 Oxidative stress can further lead to defective T cell mediated immunity.…”

Section: Discussionmentioning

confidence: 99%

Haemodialysis catheter-related blood stream infection in ESRD patients: incidence, outcome and antibiogram of the isolated organisms

et al. 2016

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“…The organisms most commonly seen in CRBSIs in longterm CVCs are Staphylococcus (Staph) aureus and coagulasenegative Staph (55,56). Several other studies (55,(57)(58)(59)(60)(61)(62)(63)(64)(65)(66)(67)(68) show that the most common other organisms causing CRBSI in short-or long-term CVC are Enterococcus faecalis, Klebsiella pneumonia, Acinetobacter baumannii, Enterobacter cloacae, Pseudomonas aeruginosa, and Escherichia coli.…”

Section: Infectionmentioning

confidence: 99%

Clinical and Regulatory Considerations for Central Venous Catheters for Hemodialysis

Silverstein

Trerotola

Clark

et al. 2018

CJASN

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Central venous catheters remain a vital option for access for patients receiving maintenance hemodialysis. There are many important and evolving clinical and regulatory considerations for all stakeholders for these devices. Innovation and transparent and comprehensive regulatory review of these devices is essential to stimulate innovation to help promote better outcomes for patients receiving maintenance hemodialysis. A workgroup that included representatives from academia, industry, and the US Food and Drug Administration was convened to identify the major design considerations and clinical and regulatory challenges of central venous catheters for hemodialysis. Our intent is to foster improved understanding of these devices and provide the foundation for strategies to foster innovation of these devices.

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Relation between Access‐Related Infection and Preinfection Serum Albumin Concentration in Patients on Chronic Hemodialysis

Abstract: Hypoalbuminemia is associated with increased risk of HD access infection. Treatment of HD access infection with antibiotics alone is associated with increased risk of death.

Cited by 12 publications

References 32 publications

Death during hospitalization in patients on chronic hemodialysis

Death during hospitalization in patients on chronic hemodialysis

Haemodialysis catheter-related blood stream infection in ESRD patients: incidence, outcome and antibiogram of the isolated organisms

Clinical and Regulatory Considerations for Central Venous Catheters for Hemodialysis

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