JAY F. DOBKIN, M.D.; MICHAEL H. MILLER, M.D.; NEAL H. STEIGBIGEL, M.D., F.A.C.P.
DOBKIN JF, MILLER MH, STEIGBIGEL NH. Septicemia in Patients on Chronic Hemodialysis. Ann Intern Med. 1978;88:28-33. doi: 10.7326/0003-4819-88-1-28
Download citation file:
Published: Ann Intern Med. 1978;88(1):28-33.
Bacterial sepsis, a major complication of chronic hemodialysis, is due mainly to infections of the vascular access site despite increasing use of internal fistulas. Sixty episodes of septicemia occurred in two chronic dialysis centers, with an incidence of 0.15 episodes of significant bacteremia per patient-dialysis-year in each. Forty-four of the 60 episodes were judged to be due to vascular access site infection by clinical, bacteriologic, and histologic criteria. Seventy percent (31 of 44) of the vascular access site-related episodes were due to staphylococci and 25% (11 of 44) to Gram-negative bacilli; nonvascular access site-related episodes were often due to transplant site infections caused by Gram-negative bacilli or streptococci. Mortality was about 18% in both vascular access site-related and nonrelated septic episodes. Bovine heterograft arteriovenous fistulas more often led to sepsis than did Brescia arteriovenous fistulas. Treatment with appropriate antibiotics was successful in most cases. Routine removal or ligation of the vascular access site was not necessary.
Learn more about subscription options.
Register Now for a free account.
Infectious Disease, Nephrology, Pulmonary/Critical Care, Renal Replacement Therapy, Multi-Organ Failure and Sepsis.
Results provided by:
Copyright © 2016 American College of Physicians. All Rights Reserved.
Print ISSN: 0003-4819 | Online ISSN: 1539-3704
Conditions of Use
This PDF is available to Subscribers Only