Vascular Access Infection Among Hemodialysis Patients in Northern Jordan: Incidence and Risk Factors

Abstract

Vascular access infection (VAI) causes significant mortality and morbidity in hemodialysis patients. The aim of this prospective, descriptive, exploratory survey of end-stage renal disease patients was to explore the incidence and risk factors of VAI. A total of 188 patients were included in the study from five different hospital/dialysis units in northern Jordan. All patients answered a questionnaire related to their vascular access (VA) and infection. Demographic information, etiology of renal failure, and infection history related to the access were also collected and analyzed. Diabetes mellitus was the most common etiology of renal failure, followed by hypertension, urinary tract infection, and congenital malformation. The infection rate was variable according to the hospital and the type of VA; of 188 patients, 65 patients had a VAI during the year of study. Of these, 36 of 64 were because of catheters, 24 of 105 were because of arteriovenous fistulas (AVFs), and 5 of 19 were because of arteriovenous graft. Of the 65 with a VAI, 58 patients had a low level of education. VAI was common in hemodialysis patients, and the risk varied substantially among different VA types and different dialysis units. The infection rate from catheters and AVFs was similar to that reported in many studies, but the infection rate in the arteriovenous graft group was lower than that for AVFs. These results can be improved by strictly following the National Kidney Foundation Disease Output Quality Initiative clinical practice guidelines for dialysis access.