RISK-FACTORS FOR BACTERIAL-INFECTIONS IN CHRONIC-HEMODIALYSIS ADULT PATIENTS - A MULTICENTER PROSPECTIVE SURVEY

All adult patients from 13 dialysis centres were prospectively followe d up for 6 months in an attempt to appraise the current risk factors f or bacterial infections in stable chronically haemodialysed patients. Parameters recorded as potential risk factors for BI were age, gender, cause of renal failure, time elapsed since the start of dialysis, his tory of transplantation, recent surgical procedure, previous bacterial infection, current immunosuppressive or erythropoietin therapy, type of angioaccess device, and serum ferritin level. Six hundred and seven patients (mean age 56.5 years, range 18-85) were enrolled in the stud y. Mean time elapsed since the start of dialysis was 4.7 years. One hu ndred and eighteen patients had developed at least one bacterial infec tion during the study period whereas 489 had remained free of bacteria l infection at the end of the follow-up. In multivariate analysis thre e parameters were found to be significant and independent risk factors for bacterial infection: previous history of bacterial infection (at least one versus no previous episode), type of angioaccess device (cat heter versus native fistula), and elevated serum ferritin level (great er versus lower than 500 mu g/l). These results support the evidence t hat impaired host defences in chronic haemodialysis patients may be se condary to the dialysis procedure and suggest that the incidence of ba cterial infection in these patients may be further reduced by appropri ate supportive therapy.