Document Detail


Hospitalizations for bacterial endocarditis after initiation of chronic dialysis in the United States.
MedLine Citation:
PMID:  12053054     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
AIMS: Bacterial endocarditis is a significant cause of morbidity and mortality but has not been studied in a national population of end-stage renal disease patients. METHODS: 327,993 dialysis patients in the United States Renal Data System initiated from 1 January 1992 to 30 June 1997 were analyzed in a historical cohort study of hospitalized bacterial endocarditis (ENDO, ICD9 Code 421.x). Renal transplant recipients were excluded. RESULTS: Hemodialysis patients had an age-adjusted incidence ratio for ENDO of 17.86 (95% confidence interval, 6.62-48.90) and peritoneal dialysis patients 10.54 (95% CI, 0.71- 158.13, not statistically significant) compared to the general population in 1996 (the National Hospital Discharge Survey). 6.1% of patients with ENDO underwent valve replacement surgery. In multivariate analysis, hemodialysis (vs. peritoneal dialysis), earlier year of dialysis, cardiac disease, and lower serum creatinine and albumin were associated with increased risk of ENDO. In Cox regression analysis, patients with ENDO had increased mortality, relative risk 1.48 (95% CI 1.45-1.73). CONCLUSIONS: Patients on chronic dialysis were at increased risk for ENDO compared to the general population. The risk for peritoneal dialysis patients was not statistically significant, possibly due to the smaller numbers of patients on this modality. Hemodialysis (vs. peritoneal dialysis) and comorbidities were the strongest risk factors for ENDO identified.
Authors:
Kevin C Abbott; Lawrence Y Agodoa
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Nephron     Volume:  91     ISSN:  0028-2766     ISO Abbreviation:  Nephron     Publication Date:  2002 Jun 
Date Detail:
Created Date:  2002-06-07     Completed Date:  2003-02-07     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0331777     Medline TA:  Nephron     Country:  Switzerland    
Other Details:
Languages:  eng     Pagination:  203-9     Citation Subset:  IM    
Copyright Information:
Copyright 2002 S. Karger AG, Basel
Affiliation:
Nephrology Service, Walter Reed Army Medical Center, Washington, DC 20307-5001, USA. kevin.abbott@na.amedd.army.mil
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MeSH Terms
Descriptor/Qualifier:
African Continental Ancestry Group
Age Distribution
Aged
Endocarditis, Bacterial / mortality*
Female
Hospitalization / statistics & numerical data*
Humans
Incidence
Kidney Failure, Chronic / mortality*
Male
Middle Aged
Multivariate Analysis
Peritoneal Dialysis / statistics & numerical data*
Renal Dialysis / statistics & numerical data*
Risk Factors
United States / epidemiology

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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