Vascular access-related infections: definitions, incidence rates, and risk factors

Am J Kidney Dis. 2008 Nov;52(5):982-93. doi: 10.1053/j.ajkd.2008.06.014. Epub 2008 Aug 29.

Abstract

Hemodialysis is associated with a high risk of morbidity and mortality, often caused by infections. Infections account for approximately 15% of all deaths in this patient population (the second leading cause after cardiovascular events) and for about one-fifth of admissions. Approximately one-fourth of infection-related admissions are caused by dialysis-associated peritonitis or vascular access infection that may lead to such significant complications as endocarditis or death. Published studies that assessed the determinants of hemodialysis-related vascular infections reported inconsistent findings. Variations in the definitions of infection among these studies despite the existence of standard guidelines proposed by at least 3 major work groups may explain, at least in part, these inconsistencies. A comprehensive in-depth review of those studies is needed to examine the inconsistencies in the published results. We first revised the existing vascular access-related infection definitions, then conducted a narrative review of the published literature that examined predictors of vascular access-related infections, highlighting the heterogeneity in methods and findings. Better understanding of the risk factors for vascular access-related infections may inform efficacious prevention strategies and lead to early detection of infections and improved patient care.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Bacteremia / epidemiology
  • Bacteremia / etiology
  • Bacterial Infections / epidemiology*
  • Bacterial Infections / etiology*
  • Catheters, Indwelling / adverse effects*
  • Humans
  • Incidence
  • Renal Dialysis*
  • Risk Factors