A Retrospective Study On Maintenance Hemodialysis Patients With Infection

Objective:To explore the risk factors of infection in patients with maintenance hemodialysis, and analysis their clinical characteristics and use of antibiotics, for providing clinical evidences of prevention and treatment for hemodialysis patients infected.Methods:Retrospective analysis 70 cases of clinical data of patients who underwent maintenance hemodialysis therapy in our hospital from Jan.2013 to Dec.2014. All patients were classified to two groups (infection group and non-infection group) based on their clinical characteristics and laboratory detection. Baseline demographic data (age, gender, BMI and primary diseases) and laboratory tests (blood, liver and biochemical routine tests) and dialysis data were reviewed. The differences and relevant of clinical and laboratory data were compared between the two groups. The risk factors associated with dialysis patients infected were analyzed, and the characteristics of infections in different parts, the relation with the primary diseases and the use of antibiotics were also evaluated.Results:Among 70 MHD patients,39 cases (55.71%) were male,31 cases (44.29%)were female.The average age is 59.96±16.89, and the average age of dialysis was 26.46±6.24m。The primary diseases included diabetic nephropathy(DN) (27 cases,38.57%), hypertensive nephropathy (HTN)(20 cases 28.57%), chronic glomerulonephritis(CGN) (19 cases, 27.14%), polycystic kidney disease(PKD) (2 cases,2.85%), and (2 cases, 2.85%) lupus nephritis(LN). The infection group had 45 patients and another 25 were in non-infected group. The rate of lung infections (51.8%) was higher than that of digestive tract (28.6%), urinary tract infection (10.7%) and multi-site infection (12.5%),28.6%. The incidence of skin, soft tissue, and catheter-related infections was uncommon. In the infection group, the rate of diabetic nephropathy, hypertensive nephropathy and chronic glomerulonephritis in primary disease was 77.77%,55% and 47.36%, respectively. The univariate analysis found that age, hemoglobin, serum albumin, total cholesterol, low-density lipoprotein, and diabetes were connected with infection in MHD patients. In multivariate logistic regression analysis older age, hypoalbuminemia, anemia and diabetes were found to be negatively associated with infection.Conclusions:1. Maintenance hemodialysis patients had a high incidence of infection.2. Lung infections, gastrointestinal and urinary tract infections are more common in MHD patients, of which lung infection was predominate.3. MHD patients with diabetes had a higher hospitalization rate and infection rate.4. Older age, hypoalbuminemia, anemia, diabetes were independently risk factor for infection in MHD patients.5. For hemodialysis patients, especially elderly patients with diabetes, special attention should be played on the nutritional status and the prevention of various complications.