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E-Poster Submission Deadline
Please prepare and upload your E-Poster no later than March 14, 2026 11.59PM CET. After this date, you will no longer be able to prepare and upload your E-poster and it will not be displayed and accessible on the congress website.
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Abstract titles should be brief and reflect the content of the abstract.
Infection-related Hospitalization is common among patients receiving maintenance hemodialysis. moreover Infection-related mortality is the 2nd leading cause of death after cardiovascular mortality. There is a scarcity of local data in the literature regarding causes of infection-related hospitalizations and preventive strategies to reduce the burden on this vulnerable cohort.
Multicenter retrospective cohort study of patients receiving maintenance Hemodialysis at Diaverum Saudi Arabia, which provides hemodialysis to patients in over 40 dialysis clinics across Saudi Arabia. We studied the infection-related hospitalization patterns reported in electronic medical records for patients aged 18 years or older and on maintenance hemodialysis for more than 90 days from 2016 to 2024 to define the underlying causes of infection-related hospitalizations and reported outcomes.
Our cohort included (10485)patients with dialysis vintage Median(range) 3.7(9.9) years, with a follow-up period Median(range) 2.7(8.5) years, mean age (54.6±16.2) years, 56.8% male, 50.2% diabetic, Comorbidity index M±SD (4.8±2.3), catheter 2895(27%). We reported (15323)Hospitalization episodes with a rate of 0.48 per patient-years at risk. Infection-related hospitalizations accounted for 3,255 episodes (21.2%), with an average hospitalization duration of M±SD (12.9±1.5) days. Urgent admission rates among our cohort were significantly reduced over the follow-up period (83.3% and 28.6%), with p-values of <0.001 for 2016-2024, respectively, demonstrating an improved level of care and the implementation of preemptive prevention and early intervention strategies for reducing urgent hospitalizations among our cohort. Mortality related to infection-related hospitalization was significantly higher than that related to non-infection-related hospitalization (14.6% vs. 11.2%), p-value 0.001.
As illustrated in Figure(1) Chest infection was the predominant cause among our patients (n-%) (816- 25%), the 2nd most common skin and soft tissue infection, mainly for diabetes-related wound infection (725-22.3%), then COVID-19-related infection(611-18.8%), which peaked during 2020-2021. Vascular access-related infections represent (210-6.5%), Gastrointestinal infection (273-8.5%), viral infections (Varicella Zoster and other viruses) (230-7.1%), Genitourinary infection (197-6%) Septicemia of unidentified origin (122-3.8%), ENT infections(22-0.7%), infective endocarditis(16-0.5%), extrapulmonary tuberculosis(16-0.5%) and Central nervous system infection (16-0.5%).
As shown in Table (1) A logistic regression model showed the following factors independently associated with higher incidence of infection-related hospitalization after adjustment to all significant covariates in the model to avoid confounder effect, higher comorbidity index ≥ 6 HR(95%CI) 1.5 (1.4-1.7) p-value <0.001, Diabetes HR(95%CI) 2.1 (1.9-2.3) p-value <0.001, Catheter as vascular access HR(95%CI) 1.6 (1.5-1.8) p-value <0.001, age ≥ 65 years old HR(95%CI) 1.03(1.02-1.04) p-value <0.001. online high volume Hemodiafiltration versus High Flux Hemodialysis 0.63 (0.54-0.71)p-value <0.001 and dialysis vintage ≥ 48 months HR(95%CI) 2.1 (1.8-2.5) p-value <0.001. Gender did not show an independent association.
Patients on maintenance hemodialysis are at higher risk of infection-related hospitalization. The leading causes are chest infections and skin and soft tissue infections. Higher comorbidity index, diabetes, catheter as vascular access, age ≥ 65 years old, dialysis vintage ≥ 48 months, and these factors are independently associated with a higher rate of infection-related hospitalization. At the same time, online high-volume Hemodiafiltration was independently associated with lower infection-related Hospitalization among our cohort. These findings underscore the importance of implementing targeted infection control strategies to reduce infection-related hospitalizations through infection prevention, reducing catheter use, enhancing diabetes care, and implementing effective vaccination programs among patients undergoing maintenance hemodialysis.
