title: [Infection-related hospitalization of hemodialysis patients].
abstract: Infection is an important cause of morbidity and mortality in hemodialysis patients. These patients are frequently hospitalized for infections. The objective of our study was to evaluate hospitalization rate for infections and to determine risk factors for infection-related hospitalizations of hemodialysis patients in Kaunas region, Lithuania. Ambulatory case records of 533 patients with end-stage renal disease, dialyzed in all hemodialysis centers in Kaunas region during the period of 2001-2004, were analyzed. Data on patient's condition and routine laboratory tests were collected in November of 2001, 2002, and 2003. These patients then were followed up for the next 12 months in order to evaluate infection-related hospitalization rate. All patients were considered new patients every year, and general analysis of three-year data was performed. Statistical analyses were carried out using SPSS (Statistical Package for Social Sciences) and STATISTICA. Univariate statistical analysis was performed comparing the groups of patients that were hospitalized because of infections and were not hospitalized. Relative risk of infection-related hospitalization was estimated using Cox regression evaluating the time to first infection-related hospitalization. The unadjusted infection-related hospitalization rate was 0.2 per patient a year (18% of all hospitalizations). The median length of hospital stay for infections was 11 days. Univariate statistical analysis showed a statistically significant association between infection-related hospitalizations and diabetes (P=0.02); lower hemoglobin (P<0.0001), creatinine (P=0.045), and albumin (P=0.01) concentrations; higher interdialytic weight gain (P=0.01). Multivariate Cox regression analysis revealed that only hemoglobin concentration (P<0.001, RR=0.96), interdialytic weight gain (P=0.002, RR=1.38), and creatinine level (P=0.02, RR=0.99) were important risk factors for infection-related hospitalization. Relative risk of infection-related hospitalization was 4.4 times greater when hemoglobin concentration was less than 100 g/L (P<0.001) and 1.9 times greater when interdialytic weight gain was more than 4% of body weight (P=0.008). CONCLUSION. In Kaunas region, infection-related hospitalizations accounted for 18% of all hospitalizations. Anemia, creatinine level, and interdialytic weight gain were important risk factors for infection-related hospitalization of hemodialysis patients.
authors.affiliation: Department of Nephrology, Kaunas University of Medicine, Kaunas, Lithuania. nefrologijos.klinika@kmuk.lt
authors.forename: Rūta
authors.initials: R
authors.lastname: Vaiciūniene
authors.forename: Vytautas
authors.initials: V
authors.lastname: Kuzminskis
authors.forename: Kristina
authors.initials: K
authors.lastname: Petruliene
authors.forename: Lina
authors.initials: L
authors.lastname: Dvaranauskaite
mesh_terms: D000328:Adult; D000368:Aged; D003627:Data Interpretation, Statistical; D005260:Female; D005500:Follow-Up Studies; D006454:Hemoglobins / Q000032:analysis; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D007239:Infections / Q000453:epidemiology*; D007676:Kidney Failure, Chronic / Q000628:therapy*; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012044:Regression Analysis; D006435:Renal Dialysis; D012306:Risk; D012307:Risk Factors; D013997:Time Factors; D015430:Weight Gain
chemical_list: D006454:Hemoglobins