[Infections as the cause of death in hemodialysis patients--nine-year retrospective analysis].

Introduction: Patients on maintenance hemodialysis (HD) are at risk for infections. They represent one of the leading causes of death in this patient population which should be considered at high risk for lethal sepsis development.

Material And Methods: Fatalities caused by infections in the period from 1997 to 2005 were analyzed retrospectively in order to investigate their frequency and relation to other causes of death. The role of vascular access (VA) and non-access related infections were also investigated Demographic characteristics, primary renal disease, length of time on HD, seasonal variation in deaths, the presence of diabetes, age over 65 and previous treatment with peritoneal dialysis (PD) were observed.

Results: Infections were the third leading cause of death (after cardiovascular and cerebrovascular causes) accounting for 10.1% of fatalities. Females were significantly more prevalent in this group in comparison to all other causes of death (63% vs. 41%, chi2=4.807; p<0.05). The difference was insignificant when all the other parameters were analyzed (age and age over 65, diabetes, HD duration, previous PD). Fatalities most frequently occurred in summer, as opposed to spring (insignificant difference). Infections related to VA were predominant, and the most important ones not related to VA were urinary tract infections and lower extremities gangrene.

Discussion And Conclusions: Our results proved infections to be the important risk factor for mortality in HD patients. It is of great importance to recognize them in their early course and treat vigorously in order to reduce mortality in this population.