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The bacterial colonization in tunneled cuffed dialysis catheter and its effects on residual renal function in incident hemodialysis patients
Authors:Jin Suk Kang  Hee Ryeong Jang  Jeong Eun Lee  Young Joo Park  Harin Rhee  Eun Young Seong  Ihm Soo Kwak  Il Young Kim  Dong Won Lee  Soo Bong Lee  Sang Heon Song
Affiliation:1.Department of Internal Medicine,Pusan National University Hospital,Busan,Republic of Korea;2.Biomedical Research Institute,Pusan National University Hospital,Busan,Republic of Korea
Abstract:

Background

The bacterial colonization of hemodialysis catheter occurs frequently and reaches to the catheter-related bloodstream infections (CRBSIs). We hypothesized bacterial colonization promotes inflammation and that might be associated with renal outcome. The aim of this study was to investigate the colonization status for tunneled cuffed dialysis catheter (TCC) and the factors for contributing to the catheter colonization and explore whether bacterial colonization would be related with declining of residual renal function (RRF).

Methods

115 patients who received TCC removal operation and underwent catheter tip culture from January 2005 to June 2014 were enrolled. The follow-up data such as urine output (UO), time to anuria and patients’ survival were collected from the patients or their family members by telephone in June, 2014.

Results

There were nineteen patients (16.5 %, 19/115) with positive tip culture (colonization group). In the analysis of demographic and biochemical parameters, there were no significant differences between both groups. Fifty of all the subjects responded to the telephone survey and ten patients (20.0 %, 10/50) belonged to colonization group. The monthly decreasing rate of UO was significantly more rapid in colonization group (p = 0.001). The survival analysis showed that colonization group had worse estimated anuria-free survival than non-colonization group (p < 0.001). In multivariate cox regression, bacterial colonization of TCC was an independent factor influencing the loss of RRF (HR 4.29, 95 % CI: 1.905–9.683, p ≤ 0.001).

Conclusions

Bacterial colonization of TCC was associated with rapid loss of RRF.
Keywords:
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