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接受透析的终末期肾病患者的感染性心内膜炎:流行病学、危险因素、诊断挑战及管理方法

Infective Endocarditis in Patients with End-Stage Renal Disease on Dialysis: Epidemiology, Risk Factors, Diagnostic Challenges, and Management Approaches.

作者信息

Issa Rochell, Chaaban Nourhan, Salahie Abdullah, Honnekeri Bianca, Parizher Gary, Xu Bo

机构信息

Department of Internal Medicine, Cleveland Clinic, Cleveland, OH 44195, USA.

Department of Cardiology, University of Toledo, Toledo, OH 43606, USA.

出版信息

Healthcare (Basel). 2024 Aug 16;12(16):1631. doi: 10.3390/healthcare12161631.

Abstract

Infective endocarditis (IE) poses a significant clinical challenge, especially among patients with end-stage renal disease (ESRD) undergoing dialysis, and is associated with high morbidity and mortality rates. This review provides a contemporary discussion of the epidemiology, risk factors, diagnostic challenges, and management strategies for IE among ESRD patients, including a literature review of recent studies focused on this vulnerable population. The review highlights the multifactorial nature of IE risk in ESRD patients, emphasizing the roles of vascular access type, dialysis modality, and comorbid conditions. It also explores the diagnostic utility of different imaging modalities and the importance of a multidisciplinary approach in managing IE, including both medical and surgical interventions. The insights from this review aim to contribute to the improvement of patient outcomes through early recognition, appropriate antimicrobial therapy, and timely surgical intervention when necessary.

摘要

感染性心内膜炎(IE)是一项重大的临床挑战,尤其在接受透析的终末期肾病(ESRD)患者中,且与高发病率和死亡率相关。本综述对ESRD患者中IE的流行病学、危险因素、诊断挑战及管理策略进行了当代讨论,包括对近期聚焦于这一脆弱人群的研究的文献综述。该综述强调了ESRD患者发生IE风险的多因素性质,着重指出了血管通路类型、透析方式及合并症的作用。它还探讨了不同成像方式的诊断效用以及多学科方法在IE管理中的重要性,包括药物和手术干预。本综述的见解旨在通过早期识别、适当的抗菌治疗以及必要时及时的手术干预,为改善患者预后做出贡献。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/68e7/11353797/431411d0ff6b/healthcare-12-01631-g001.jpg

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