NATIONAL SURVEILLANCE OF DIALYSIS-ASSOCIATED DISEASES IN THE UNITED-STATES, 1993

To determine trends in a number of hemodialysis associated diseases an d practices, the Centers for Disease Control and Prevention, in collab oration with the Health Care Financing Administration, performed a mai l survey of 2,304 chronic hemodialysis centers in the United States in 1993. By the end of 1993, at least three doses of hepatitis B vaccine were administered to 29% of patients and 76% of staff at responding c enters. Hepatitis B surface antigen was present at low frequency in pa tients (incidence = 0.1%, prevalence 1.2%) and staff members (incidenc e = 0.02%, prevalence = 0.3%). The 1993 incidence of hepatitis B virus infection among patients was higher at centers that accepted hepatiti s B surface antigen positive patients but did not use a separate room and dialysis machine for treatment of these patients, government and p rofit (versus nonprofit) centers, and centers in four End Stage Renal Disease Networks. The prevalence of antibody to hepatitis C virus was 9.7% among patients and 1.6% among staff members. Pyrogenic reactions in the absence of septicemia were reported by 21% of centers and assoc iated with use of high flux dialysis. Human immunodeficiency virus inf ection was known to be present in 1.5% of patients; 34% of centers rep orted providing hemodialysis to one or more human immunodeficiency vir us infected patients.