Risk factors associated with sepsis of vascular access in patients undergoing hemodialysis

Abstract

Introduction: Infections are causes of morbidity and mortality in patients with Chronic Renal Disease undergoing hemodialysis. Objective:To identify the risk factors associated with sepsis of vascular access in patients undergoing hemodialysis. Material and Methods:Prospective analytical observational study. The sample was composed of all patients who underwent repeated hemodialysis in the service of Ambulatory Hemodialysis with at least three months in the program and no evidences of infection at the beginning of the observation. The variables used were age, sex, time on hemodialysis, cause of chronic renal disease, type of vascular access, type of infection, number of reports, microbiology, hemoglobin, serum albumin, and body mass index. The information was processed automatically. Tests of homogeneity and logistic regression were used. Results: A total of 102 patients were studied, most of them aged 50 to 69 years, and the male sex predominated in the study. Arterial hypertension and Diabetes Mellitus were the most reported antecedents. Infection was observed in 23 patients, which predominated in those with less than one year of hemodialysis, in its entirety with central venous catheter as a vascular access route. Microbiological isolates corresponded mainly to Staphylococcus aureus. The patients with sepsis presented mean levels of hemoglobin, and lower albumin levels. The risk of sepsis in patients with central venous catheter was significantly higher with regard to the use of arteriovenous fistula. Conclusions: The use of a central venous catheter for hemodialysis is an independent risk factor for the development of infection in patients undergoing hemodialysis in the Institute of Nephrology.Keywords: infection, sanitary care, central venous access, catheter for hemodialysis, Staphylococcus aureus, Chronic renal Disease.