BACKGROUND: Infection is a common cause of mortality and morbidity in haemodialysis patients. Few prospective studies have examined the clinical consequences of infection-related hospitalizations in haemodialysis patients or the risk factors predictive of clinical outcomes. METHODS: The outcomes of all first infection-related hospitalizations of patients enrolled in the HEMO Study were categorized in terms of mortality, requirement for intensive care unit (ICU) stay and length of hospitalization. In addition, the association of hospitalization outcomes with clinical and laboratory parameters was evaluated. RESULTS: Among the 783 first infection-related hospitalizations, 57.7% had a severe outcome (death, ICU stay or hospitalization >/=7 days). The likelihood of a severe outcome increased with patient age (P<0.0001) and with decreased serum albumin (P<0.001). The frequency of a severe outcome varied greatly by infectious disease category (P<0.001), being highest for cardiac infections (95.6%) and infection of unknown source (68.4%), and lowest for urinary tract infections (35.5%) and access-related infections (43.8%). On multivariate analysis, hospitalization outcome was independently associated with patient age, serum albumin and disease category, but not with the randomized Kt/V or flux, gender, race or diabetic status. CONCLUSION: In summary, infection-related hospitalizations are associated with substantial morbidity. Patient age, serum albumin and infectious disease category are independently correlated with the hospitalization outcome, and can be used to estimate the likelihood of serious outcomes at the time of hospital admission.
BACKGROUND: Infection is a common cause of mortality and morbidity in haemodialysis patients. Few prospective studies have examined the clinical consequences of infection-related hospitalizations in haemodialysis patients or the risk factors predictive of clinical outcomes. METHODS: The outcomes of all first infection-related hospitalizations of patients enrolled in the HEMO Study were categorized in terms of mortality, requirement for intensive care unit (ICU) stay and length of hospitalization. In addition, the association of hospitalization outcomes with clinical and laboratory parameters was evaluated. RESULTS: Among the 783 first infection-related hospitalizations, 57.7% had a severe outcome (death, ICU stay or hospitalization >/=7 days). The likelihood of a severe outcome increased with patient age (P<0.0001) and with decreased serum albumin (P<0.001). The frequency of a severe outcome varied greatly by infectious disease category (P<0.001), being highest for cardiac infections (95.6%) and infection of unknown source (68.4%), and lowest for urinary tract infections (35.5%) and access-related infections (43.8%). On multivariate analysis, hospitalization outcome was independently associated with patient age, serum albumin and disease category, but not with the randomized Kt/V or flux, gender, race or diabetic status. CONCLUSION: In summary, infection-related hospitalizations are associated with substantial morbidity. Patient age, serum albumin and infectious disease category are independently correlated with the hospitalization outcome, and can be used to estimate the likelihood of serious outcomes at the time of hospital admission.
Authors: Lorien S Dalrymple; Yi Mu; Patrick S Romano; Danh V Nguyen; Glenn M Chertow; Cynthia Delgado; Barbara Grimes; George A Kaysen; Kirsten L Johansen Journal: Am J Kidney Dis Date: 2015-01-30 Impact factor: 8.860
Authors: Claire H den Hoedt; Michiel L Bots; Muriel P C Grooteman; Neelke C van der Weerd; E Lars Penne; Albert H A Mazairac; Renée Levesque; Peter J Blankestijn; Menso J Nubé; Piet M ter Wee; Marinus A van den Dorpel Journal: Clin J Am Soc Nephrol Date: 2014-01-23 Impact factor: 8.237
Authors: Michel Chonchol; Tom Greene; Yingying Zhang; Andrew N Hoofnagle; Alfred K Cheung Journal: J Am Soc Nephrol Date: 2015-05-13 Impact factor: 10.121
Authors: Junichi Ishigami; Morgan E Grams; Alexander R Chang; Juan J Carrero; Josef Coresh; Kunihiro Matsushita Journal: Am J Kidney Dis Date: 2016-11-22 Impact factor: 8.860
Authors: Jennifer K Broom; Stacey O'Shea; Sridevi Govindarajulu; E Geoffrey Playford; Carmel M Hawley; Nicole M Isbel; Scott B Campbell; David W Mudge; Sally Carpenter; Barbara C Johnson; Neil P Underwood; David W Johnson Journal: BMC Nephrol Date: 2009-08-20 Impact factor: 2.388