Effect of Different Vascular Accesses on Inflammatory Markers and Outcome in Maintenance Hemodialysis Patients

Abstract

Abstract Background Haemodialysis is a vital treatment for all uremic patients to survive. For those who need dialysis for a long time, establishing and maintaining permanent vascular accesses with good function is a crucial condition for prolonging their survival. Aim of the Work To study the effect of different types of vascular access on infection risk (apparent, hidden infection, patterns of microbial infection, antibiotic sensitivity, and outcome among maintenance hemodialysis patients). Patients and Methods This study is a prospective cohort study. This study conducted in Ain Shams University Hospitals, Nephrology Department Hemodialysis units. In 6 months. Results In the current study we found that Mean ± SD of Age (years) 49.5±8.4 and Duration of HD (years) was 3.2±1.9. Males and females were almost equal (46.0 % and 54.0% respectively). Cases from El-Demerdash and ASHUSH were 60.3% and 39.7% respectively. Catheters were temporary catheter, AVF and AVG; 49.2%, 31.7% and 19.0% respectively. In the current study we found that less than fifth of cases had Leucocytosis and Elevated procalcitonin in months 2 and 3. No significant statistical differences according to catheter type regarding demographic characteristics. Leucocytosis and Elevated procalcitonin in months 2 and 3 were most frequent in temporary catheter, followed by AVG and least frequent in AVF, the differences were significant only in leucocytosis. In the current study we found that Mean ± SD of temporary catheter duration (weeks) was 3.4±1. The access sites were Right jugular, right subclavian, left jugular and left subclavian; 41.9%, 25.8%, 22.6% and 9.7% respectively. Duration of temporary catheter was significantly higher in cases with peripheral positive culture. No statistically significant difference according to peripheral culture findings regarding temporary catheter access site. Duration of temporary catheter was significantly higher in cases with central positive culture. No significant statistical difference according to peripheral culture findings regarding temporary catheter access site. Conclusion the growing body of knowledge in nephrology and infectious disease management, offering insights that can inform clinical practice and improve patient outcomes in the haemodialysis setting.