1. Home
  2. Vol 54, No 3 (2022)
  3. Susilo

Risk Factors for Temporary Vascular Access Infection in Patients with End-Stage Renal Disease Undergoing Hemodialysis in Cipto Mangunkusumo Hospital

Adityo Susilo, Kresna Dharma Suryana, Pringgodigdo Nugroho, Muhadi Muhadi, Beryl Alodia, Leonard Nainggolan

Abstract


Background: Temporary vascular access is used to provide adequate hemodialysis for patients who are initiating dialysis or are awaiting maturation of a more permanent vascular access. However, infection is one of the most frequent complications of using temporary vascular access and is the second leading cause of death in patients undergoing hemodialysis after cardiovascular events. There has been no research on the risk factors for the incidence of infection in patients using temporary vascular access in Indonesia. Methods: This is a retrospective cohort study utilizing secondary data from medical records of 318 subjects aged 18 years and older with end-stage renal disease and undergoing hemodialysis using temporary vascular access at Cipto Mangunkusumo Hospital. Results: Temporary vascular access infection was found in 125 of 318 subjects (39.3%). The risk factors of temporary vascular catheter infection in the multivariate analysis were females (OR 1.731; 95% CI 1.050-2.854; p=0.032), low hemoglobin levels (OR 2.293; 95% CI 1.353-3.885; p=0.002), presence of diabetes mellitus (OR 2.962; 95% CI 1.704-5.149; p<0.001) and duration of catheter insertion (OR 5.322; 95% CI 1.871-15-135; p=0.002). The association between ferritin and catheter insertion site was not analyzed as a risk factor because it was not performed in all subjects. Conclusion: The incidence of infection in patients with end -stage renal disease undergoing hemodialysis using temporary vascular access at Cipto Mangunkusumo Hospital was 39.3%. Female gender, low hemoglobin level, diabetes mellitus, and duration of catheter insertion were risk factors for temporary vascular access infection.


Keywords


Risk factors; temporary vascular access infection; end-stage renal disease; chronic kidney disease; hemodialysis

References


National Kidney Foundation. Update of the KDOQI TM clinical practice guideline for hemodialysis adequacy; 2015.

Collins AJ, Foley RN, Chavers B, et al. US renal data system 2011 annual data report. Am J Kidney Dis. 2012;59(1):A7.

Demirci R, Sahtiyanci B, Bakan A, Akyuz O. The predictors of catheter-related bloodstream infections in patients undergoing hemodialysis: A single center experience. J Vasc Access. 2021;112972982199883.

Sahli F, Feidjel R, Laalaoui R. Hemodialysis catheter-related infection: rates, risk factors and pathogens. J Infect Public. 2017;10(4):403-8.

Lok C, Mokrzycki M. Prevention and management of catheter-related infection in hemodialysis patients. KI. 2011;79(6):587-98.

Borges PRR, Bedendo J. Risk factors associated with temporary catheter-related infection in patients on dialysis treatment. Text Context Nurs. 2015;24(3):680-5.

Seifert A, Herrath D, Schaefer K. Iron overload, but not treatment with desferrioxamine favours the development of septicemia in patients on maintenance hemodialysis. Q J Med. 1987;65(248):1015-24.

Knezevic V, Djurdjevic-Mirkovic T, Bozic D, et al. Risk factors for catheter-related infections in patients on hemodialysis. Vojnosanit Pregl. 2018;75(2):159-66.

Menegueti MG , Betoni NC, Bellissimo-rodrigues F, Romão EA. Central venous catheter-related infections in patients receiving short-term hemodialysis therapy: Incidence, associated factors, and microbiological aspects. Rev Soc Bras Med Trop. 2017;50(6):783- 7.

Çaylan R, Yilmaz G, Sözen EE, Aydin K, KöksalI. Incidence and risk factors for bloodstream infections stemming from temporary hemodialysis catheters. Turk J Med Sci. 2010;40(6):835-41.

Bream P. Update on insertion and complications of central venous catheters for hemodialysis. Semin Intervent Radiol. 2016;33(01):31-8.

Oliver M, Callery S, Thorpe K, Schwab S, Churchill D. Risk of bacteremia from temporary hemodialysis catheters by site of insertion and duration of use: A prospective study. KI. 2000;58(6):2543-5.

Setiati S, Rizka A. Imunosenesens. In: Setiati S, Alwi I, Sudoyo AW, et al, eds. Buku ajar ilmu penyakit dalam. 3rd edition. Jakarta: Interna Publishing; 2014. p. 3680-5.

Boelaert JR, Daneels RF, Schurgers ML, Matthys EG, Gordts BZ. Iron overload in haemodialysis patients increases the risk of bacteraemia: A prospective study. Nephrol Dial Transplant. 1990;5:130-4.

Kernan K, Carcillo J. Hyperferritinemia and inflammation. Int Immunol. 2017;29(9):401-9.

Adeniyi OA, Tzamaloukas AH. Relation between access-related infection and preinfection serum albumin concentration in patients on chronic hemodialysis. Hemodial Int. 2003;7(4):304-10.

Miller LM, Clark E, Dipchand C, et al. Hemodialysis tunneled catheter-related infections. Can J Kidney Heal Dis. 2016;3:1-11.

Trianto, Semadi N, Widiana G. Faktor risiko infeksi kateter hemodialisis double lumen non-tunneled. J Ilmu Kedokteran. 2014;46:25-30.

Lafrance J, Rahme E, Lelorier J, Iqbal S. Vascular access-related infections: Definitions, incidence rates, and risk factors. Am J Kidney Dis. 2008;52(5):982-93.


Full Text: PDF

Refbacks

  • There are currently no refbacks.