Subject(s)
Arteriovenous Shunt, Surgical/instrumentation , Axillary Artery/surgery , Blood Vessel Prosthesis Implantation/instrumentation , Blood Vessel Prosthesis , Heart Atria/surgery , Kidney Failure, Chronic/therapy , Renal Dialysis , Axillary Artery/physiopathology , Heart Atria/physiopathology , Humans , Kidney Failure, Chronic/diagnosis , Male , Middle Aged , Prosthesis Design , Regional Blood Flow , Reoperation , Treatment OutcomeABSTRACT
BACKGROUND: The major complication of tunneled vascular catheters in dialysis patients is infection. In preliminary work, an association was noted between hepatitis C virus (HCV) infection and bacteremia in these patients. On this basis, we theorized that HCV infection may be associated with bacteremia in dialysis patients with tunneled catheters. METHODS: We conducted a two-phase clinical study to define the association between HCV infection and bacteremia in hemodialysis patients with catheters. Phase 1 was a cross-sectional study designed to assess the association between HCV serologic status and bacteremia. Phase 2 was a prospective study that examined the relationship between HCV viral load and bacteremia. RESULTS: In Phase 1, HCV (+) patients had a significantly greater prevalence of bacteremia than HCV (-) patients (61 vs 7.7% respectively, P < 0.05). In Phase 2, the presence of detectable virus was associated with a numerical trend toward an increase in the incidence of bacteremia (40 vs 0% for patients with and without detectable virus, respectively, P = 0.09). CONCLUSION: These studies suggest that HCV infection may be associated with the development of bacteremia in hemodialysis patients with tunneled catheters.
