title: Sepsis in hemodialysis patients.
abstract: BACKGROUND
  Bacterial infections are very common in End Stage Renal Disease (ESRD) patients. The diagnosis of sepsis in such patients is often challenging and requires a high index of suspicion. The aim of this study is to report on a series of patient with ESRD on hemodialysis (HD) diagnosed with sepsis.
  
  
  METHODS
  Single center retrospective study looking at ESRD on HD who presented to our tertiary hospital were retrieved. Inclusion criteria included a discharge diagnosis of sepsis, septic shock or bacteremia.
  
  
  RESULTS
  Our sample was composed of 41 females and 49 males, with a mean age of 70 ± 15 years. Infections from the HD catheters followed by lower respiratory tract infections were the most common cause of bacteremia. IV fluid replacement for the first 6 and 24 h were 0.58 and 1.27 l respectively. Vasopressors were used in 30 patients with norepinephrine, dopamine and dobutamine used in 22, nine and one patients respectively. Out of 90 subjects, 24 (26.6 %) were dead within the same hospital visit. the 28 days out of hospital mortality was 25.6 %. There was no significant difference in mortality in patients who presented with less than two SIRS or two or more SIRS criteria.
  
  
  CONCLUSIONS
  This is the first study looking at an in depth analysis of sepsis in the specific dialysis population and examining the influence of fluid resuscitation, role of SIRS criteria and vasopressor use on their mortality.
authors.affiliation: Department of Emergency Medicine, American University of Beirut, Beirut, Lebanon. ga66@aub.edu.lb.
authors.forename: Gilbert
authors.initials: G
authors.lastname: Abou Dagher
authors.affiliation: Department of Emergency Medicine, Henry Ford Hospital, Detroit, Michigan, USA. elieharmouche@gmail.com.
authors.forename: Elie
authors.initials: E
authors.lastname: Harmouche
authors.affiliation: Department of Emergency Medicine, American University of Beirut, Beirut, Lebanon. ej05@aub.edu.lb.
authors.forename: Elsy
authors.initials: E
authors.lastname: Jabbour
authors.affiliation: Department of Emergency Medicine, American University of Beirut, Beirut, Lebanon. rb52@aub.edu.lb.
authors.forename: Rana
authors.initials: R
authors.lastname: Bachir
authors.affiliation: Department of Emergency Medicine, American University of Beirut, Beirut, Lebanon. dz12@aub.edu.lb.
authors.forename: Dina
authors.initials: D
authors.lastname: Zebian
authors.affiliation: Department of Emergency Medicine, American University of Beirut, Beirut, Lebanon. rb94@aub.edu.lb.
authors.forename: Ralphe
authors.initials: R
authors.lastname: Bou Chebl
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D016470:Bacteremia / Q000453:epidemiology / Q000628:therapy; D055499:Catheter-Related Infections / Q000453:epidemiology; D005260:Female; D005440:Fluid Therapy; D006305:Health Status Indicators; D006801:Humans; D008297:Male; D008875:Middle Aged; D006435:Renal Dialysis / Q000706:statistics & numerical data*; D012141:Respiratory Tract Infections / Q000453:epidemiology*; D012189:Retrospective Studies; D018805:Sepsis / Q000175:diagnosis* / Q000453:epidemiology* / Q000401:mortality / Q000628:therapy; D012772:Shock, Septic / Q000453:epidemiology / Q000628:therapy; D062606:Tertiary Care Centers; D014662:Vasoconstrictor Agents / Q000008:administration & dosage
chemical_list: D014662:Vasoconstrictor Agents