Bi Shu-Hong, Tang Wen, Rigodanzo-Massey Nives, Young Bessie A, Blagg Christopher R, Wang Tao, Ahmad Suhail
Division of Nephrology, Peking University Third Hospital, Beijing, China.
Blood Purif. 2015;40(3):187-93. doi: 10.1159/000433517. Epub 2015 Aug 25.
Infection is an important cause of hospitalization and death in patients receiving hemodialysis (HD). Few studies have examined infection-related hospitalizations in home HD (HHD) population. The purpose of this study was to examine the scope of infections and the effect of HHD modality (daily home HD (DHD) and conventional home HD (CHD)) on infection-related hospitalizations in HHD patients.
The study was performed in a large cohort of HHD patients. Infection-related hospitalizations during July 1, 2005, and August 30, 2010, were abstracted from the centralized computer system. Data on demographics, dialysis vintage and dialysis modality were analyzed.
One hundred sixty-five patients were included. During a median follow-up of 5 years, infection-related hospitalizations were observed in approximately 35.8% of all hospitalizations, which was the first cause for hospitalization. Rates of non-access-related infections were observed to be higher than that of access-related infections (1.7:1). Rates (per 100 person-years) of soft-tissue infection, pneumonia and sepsis ranged from 0.85 to 1.82 in patients on HHD. Meanwhile, access-related infection was the main cause for access-related hospitalizations (34.8%). Cox regression analysis showed that the usage of different dialysis modalities was not associated with a high risk for infection-related hospitalizations in HHD patients.
Infection-related hospitalization occurred frequently in HHD patients. A broad range of infections, many unrelated to dialysis access, resulted in hospitalization in this population. HHD modalities were not associated with infection-related hospitalizations in HHD patients.
感染是接受血液透析（HD）患者住院和死亡的重要原因。很少有研究调查家庭血液透析（HHD）人群中与感染相关的住院情况。本研究的目的是探讨感染的范围以及HHD模式（每日家庭血液透析（DHD）和传统家庭血液透析（CHD））对HHD患者与感染相关住院的影响。
该研究在一大群HHD患者中进行。从集中式计算机系统中提取2005年7月1日至2010年8月30日期间与感染相关的住院情况。分析了人口统计学、透析病程和透析模式的数据。
纳入了165名患者。在中位随访5年期间，在所有住院患者中约35.8%观察到与感染相关的住院情况，这是住院的首要原因。观察到非通路相关感染的发生率高于通路相关感染（1.7:1）。HHD患者软组织感染、肺炎和败血症的发生率（每100人年）在0.85至1.82之间。同时，通路相关感染是通路相关住院的主要原因（34.8%）。Cox回归分析表明，不同透析模式的使用与HHD患者与感染相关住院的高风险无关。
HHD患者中与感染相关的住院情况频繁发生。多种感染，许多与透析通路无关，导致该人群住院。HHD模式与HHD患者与感染相关的住院情况无关。
