Reducing Catheter-Related Infections in Hemodialysis Patients

[摘要] Not all hemodialysis accesses are created equal: Compared with patients with ESRD who have an arteriovenous fistula, those with a tunneled central venous catheter have a 15-fold increased risk of catheter-related bloodstream infection (CRBSI) and an all-cause mortality rate ranging from 12% to 25% (1,2). Ten percent to 20% of CRBSIs are associated with metastatic complications, such as endocarditis, septic arthritis, and epidural abscess, and they cause considerable financial and physical burdens from catheter loss, repeated access procedures, and hospital admissions (2). A single-center study found that a CRBSI resulted in an average hospital stay of 11 days and cost approximately $23,000 (3); several other studies support these data (4,5). Despite the Fistula First Initiative, nearly 80% of patients initiate hemodialysis with a central venous catheter (6).

[学科分类] 泌尿医学

[关键词] Bone marrow necrosis;Sickle cell disease;Hyperhemolysis syndrome