ArticleThe Korean journal of internal medicine2026
Hemodialysis vascular access infections: epidemiology and risk factors for treatment failure.
Article in The Korean journal of internal medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
BACKGROUND/
aimsInfection remains the second leading cause of mortality in patients with end-stage renal disease (ESRD). Despite the direct relationship between hemodialysis vascular access-related infections (HD-VARI) and both prognosis and mortality in ESRD patients, there is a paucity of research in this area.
methodsThis retrospective study was performed at a tertiary care hospital in Seoul, Korea, from 2009 to 2020. Medical records of adult patients diagnosed with HD-VARI were assessed. We analyzed the distribution of microorganisms, clinical characteristics according to vascular access type, and evaluated risk factors for treatment failure.
resultsData from a total of 367 patients were included over the 12-year study period. Based on vascular access type, 293 (79.8%) had arteriovenous graft infections, 29 (7.9%) had arteriovenous fistula infections, and 45 (12.3%) had tunneled cuffed catheter infections. Thirty-one (8.4%) patients experienced treatment failure within 90 days. Multivariate analysis identified male sex (odds ratio [OR], 2.343; 95% confidence interval [CI], 1.041-5.274) and metastatic infection (OR, 4.297; 95% CI, 1.516-12.178) as independent predictors of 90-day infection-related treatment failure. Subtotal or total excision (removal) of the infected vascular access significantly decreased the risk of 90-day infection-related treatment failure (OR, 0.337; 95% CI, 0.129-0.876).
conclusionRemoval of infected vascular access played a crucial role in reducing infection-related deaths or relapses within 90 days. Management of vascular access infection should be individualized based on patient-specific factors.
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