title: Infection-Related Hospitalizations in Home Hemodialysis Patients.
abstract: OBJECTIVE
  Infection is an important cause of hospitalization and death in patients receiving hemodialysis (HD). Few studies have examined infection-related hospitalizations in home HD (HHD) population. The purpose of this study was to examine the scope of infections and the effect of HHD modality (daily home HD (DHD) and conventional home HD (CHD)) on infection-related hospitalizations in HHD patients.
  
  
  METHODS
  The study was performed in a large cohort of HHD patients. Infection-related hospitalizations during July 1, 2005, and August 30, 2010, were abstracted from the centralized computer system. Data on demographics, dialysis vintage and dialysis modality were analyzed.
  
  
  RESULTS
  One hundred sixty-five patients were included. During a median follow-up of 5 years, infection-related hospitalizations were observed in approximately 35.8% of all hospitalizations, which was the first cause for hospitalization. Rates of non-access-related infections were observed to be higher than that of access-related infections (1.7:1). Rates (per 100 person-years) of soft-tissue infection, pneumonia and sepsis ranged from 0.85 to 1.82 in patients on HHD. Meanwhile, access-related infection was the main cause for access-related hospitalizations (34.8%). Cox regression analysis showed that the usage of different dialysis modalities was not associated with a high risk for infection-related hospitalizations in HHD patients.
  
  
  CONCLUSIONS
  Infection-related hospitalization occurred frequently in HHD patients. A broad range of infections, many unrelated to dialysis access, resulted in hospitalization in this population. HHD modalities were not associated with infection-related hospitalizations in HHD patients.
authors.affiliation: Division of Nephrology, Peking University Third Hospital, Beijing, China.
authors.forename: Shu-Hong
authors.initials: SH
authors.lastname: Bi
authors.forename: Wen
authors.initials: W
authors.lastname: Tang
authors.forename: Nives
authors.initials: N
authors.lastname: Rigodanzo-Massey
authors.forename: Bessie A
authors.initials: BA
authors.lastname: Young
authors.forename: Christopher R
authors.initials: CR
authors.lastname: Blagg
authors.forename: Tao
authors.initials: T
authors.lastname: Wang
authors.forename: Suhail
authors.initials: S
authors.lastname: Ahmad
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006437:Hemodialysis, Home / Q000009:adverse effects* / Q000401:mortality; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D018410:Pneumonia, Bacterial / Q000209:etiology* / Q000401:mortality / Q000473:pathology; D051436:Renal Insufficiency, Chronic / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D012189:Retrospective Studies; D012307:Risk Factors; D018805:Sepsis / Q000209:etiology* / Q000401:mortality / Q000473:pathology; D016019:Survival Analysis