Clinical Characteristics And Risk Factors Of Concomitant Infection In Maintenance Hemodialysis Patients

ObjectivesTo investigate the clinical characteristics of concurrent infection in patients with chronic renal failure undergoing maintenance hemodialysis and to analyze the related risk factors.Methods113 patients with chronic renal failure who received maintenance hemodialysis（MHD）treatment in the blood purification treatment center of our hospital from January 2013 to December 2017 were selected as the research objects with complete clinical records.The age,sex,dialysis age,primary disease,cardio-cerebrovascular complications,central venous catheterization and other general conditions of 113patients were retrospectively analyzed,as well as laboratory examination data of hemoglobin（Hb）,c-reactive protein（CRP）,plasma albumin（Alb）,serum creatinine（Scr）before dialysis,and urea nitrogen（BUN）before dialysis.113 patients were divided into the infected group and the non-infected group according to whether they were complicated with infection or not.The primary disease,site of infection,species and distribution of pathogenic bacteria,and outcome of infection were analyzed.The difference of each index between the two groups was compared by 2 test and t test,and the independent risk factors of concurrent infection in maintenance hemodialysis patients were analyzed by binary Logistic regression.ResultsAmong 113 patients receiving maintenance hemodialysis for chronic renal failure,80 were males and 33 were females,with an average age of 58.04±13.25years old and an average dialysis age of 37.80±34.47 months.The infection rate was52.2%.Diabetic nephropathy（DN）is the most common primary disease in infected patients,pulmonary infection is the most important infection site,and the main pathogenic bacteria is gram-negative bacillus infection.Age,length of hospital stay,diabetes mellitus,cardiac insufficiency,albumin（Alb）,hemoglobin（Hb）,c-reactive protein（CRP）,carbon dioxide binding force（CO₂CP）and b-type natriuretic peptide（BNP）were statistically significant in the infected group and the non-infected group（P<0.05）.Gender,central venous catheterization,dialysis age,predialysis serum creatinine（Scr）,predialysis urea nitrogen（BUN）,total cholesterol（TC）,low-density lipoprotein cholesterol（LDL-C）,high-density lipoprotein cholesterol（HDL-C）,total protein（TP）,total parathyroid hormone（iPTH）,calcium,and other numerical differences were not statistically significant.Meanwhile,Logistic regression analysis showed that age,anemia and hypoalbuminemia were independent risk factors for infection in hemodialysis patients.Conclusions1.The incidence of concurrent infection in MHD patients was 52.2%.The main primary disease was diabetic nephropathy,and the main pathogen of concurrent infection was gram-negative bacterial.2.The main sites of concurrent infection in MHD patients are lung,skin and soft tissue,and catheter-related infections.3.Major risk factors for concurrent infection in MHD patients include advanced age,anemia,and low serum albumin levels.