Infective endocarditis in patients receiving chronic hemodialysis: clinical features and outcome.
OBJECTIVE
Patients undergoing chronic hemodialysis are at increased risk of infective endocarditis (IE), and mortality is high in this group. The study aim was to determine clinical features and outcome of IE in patients with chronic renal failure and receiving hemodialysis.


METHODS
Between 1987 and 2002, all consecutive patients with infective endocarditis treated at the authors' institution who were not intravenous drug abusers were selected prospectively. A comparative analysis was performed of patients undergoing hemodialysis and other patients in the series.


RESULTS
A total of 241 cases of IE was diagnosed, and 14 patients (6%) were receiving hemodialysis. A lower frequency of known predisposing heart disease (14% versus 74%, p <0.01) and prosthetic valve endocarditis (0% versus 35%, p <0.05) and a higher rate of negative blood cultures (21% versus 12%, p <0.05) were detected in hemodialysis patients. Early surgery was performed in 50% of patients in both groups. The frequency of complications was similar in both groups, but early (43% versus 16%, p = 0.03) and late (22% versus 9%, p <0.05) mortality were higher in hemodialysis patients.


CONCLUSIONS
Patients with IE who are undergoing hemodialysis have a lower frequency of predisposing heart disease and higher rates of negative blood cultures. Although patient groups were similarly treated, early and late mortality was significantly higher among those receiving dialysis.
Ruiz
Martin
M
Servicio de Cardiología, Hospital Universitario Reina Sofía, Córdoba, Spain. mruor@supercable.es
Sánchez
Manuel P A
MP
Domínguez
Juan C C
JC
Pineda
Soledad O
SO
Peñas
Elías R
ER
Rubio
María D M
MD
Ortega
Mónica D
MD
Belsué
Federico V
FV
D004697:Endocarditis, Bacterial / Q000175:diagnosis / Q000453:epidemiology* / Q000601:surgery; D005260:Female; D006349:Heart Valve Diseases / Q000453:epidemiology; D006350:Heart Valve Prosthesis / Q000382:microbiology; D006351:Heart Valves / Q000382:microbiology; D006801:Humans; D007676:Kidney Failure, Chronic / Q000401:mortality / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D016459:Prosthesis-Related Infections / Q000453:epidemiology; D006435:Renal Dialysis; D013030:Spain / Q000453:epidemiology