Tunneled right atrial catheter infection presenting as renal failure

We report two cases of progressive renal failure secondary to membranoproli ferative glomerulonephritis associated with subclinical septicemia from a t unneled right atrial catheter used for home parenteral nutrition administra tion. Although the occurrence of line infection and septicemia is a common complication of central venous catheters, a review of the literature reveal s only one case report of renal failure secondary to an infected implanted central venous device. Both patients presented with azotemia and had biopsy -proven membranoproliferative glomerulonephritis, accompanied by leukocytoc lastic vasculitis. In both cases, removal of the right atrial catheter and prolonged antibiotic therapy was effective in resolving the ongoing infecti on and resulted in marked improvement in renal function. A high index of su spicion for catheter sepsis should be maintained in patients with tunneled right atrial catheters presenting with subacute renal failure.