Urinary Tract Infection in Hemodialysis-Dependent End-Stage Renal Disease Patients

Kaori Yamashita; Yudai Ishiyama; Maki Yoshino; Hidekazu Tachibana; Daisuke Toki; Ryuichiro Konda; Tunenori Kondo

doi:10.2147/RRU.S346020

Urinary Tract Infection in Hemodialysis-Dependent End-Stage Renal Disease Patients

Res Rep Urol. 2022 Jan 16:14:7-15. doi: 10.2147/RRU.S346020. eCollection 2022.

Authors

Kaori Yamashita^{1

2}, Yudai Ishiyama¹, Maki Yoshino¹, Hidekazu Tachibana¹, Daisuke Toki¹, Ryuichiro Konda², Tunenori Kondo¹

Affiliations

¹ Department of Urology, Tokyo Women's Medical University Medical Center East, Tokyo, Japan.
² Tomioka Clinic, Tokiwa Foundation, Fukushima, Japan.

Abstract

Introduction: The aim of this study was to analyze urinalysis findings and urinary bacterial culture in hemodialysis-dependent end-stage renal disease patients. The research goal was to understand the proportion, risk factors, and the causative organisms of urinary tract infection in hemodialysis-dependent end-stage renal disease patients.

Materials and methods: Between May 2020 and June 2021, this study included 100 hemodialysis-dependent end-stage renal disease patients (50 male patients and 50 female patients). The urine underwent microscopic examination, pyuria was defined as ≥5 white blood cells per high-power field, and urinary bacterial cultures were conducted for patients with pyuria. Bacteriuria was defined as ≥10⁴ colony-forming units/mL in men and ≥10⁵ colony-forming units/mL in women. Daily urine output was investigated by oral listening. Postvoiding residual urine volume was measured.

Results: Fifty-six percent of male patients and 30% of female patients had normosthenuria, 24% of male patients and 38% of female patients had pyuria, and 20% of male patients and 32% of female patients had a urinary tract infection. A comparison of normosthenuria and urinary tract infection revealed no statistically significant difference in age, time on dialysis, daily urine output, and postvoiding residual urine volume. The proportion of female patients among those with normosthenuria was 34.8%, whereas the proportion of female patients among those with UTI was 61.5%. Urinary bacterial cultures showed that the major causative organisms were Escherichia coli (45%; 18/40 cultures) and extended spectrum beta-lactamase-producing Escherichia coli (17.5%; 7/40 cultures).

Conclusion: The incidence of urinary tract infection was higher in female patients than in male patients. The proportion of resistant bacteria as the causative organisms was high in hemodialysis-dependent end-stage renal disease patients. Urinary bacterial culture should be checked while patients are able to void urine.

Keywords: bacteriuria; pyuria; renal dialysis; urinary tract infection; urine.