CLINICAL FINDINGS IN PATIENTS DIAGNOSED WITH INFECTIVE ENDOCARDITIS IN A HEMODIALYSIS UNIT IN MEXICO

 

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CLINICAL FINDINGS IN PATIENTS DIAGNOSED WITH INFECTIVE ENDOCARDITIS IN A HEMODIALYSIS UNIT IN MEXICO

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Cynthia Michelle
Lujano Navarro
Cynthia Michelle Lujano Navarro cymichluna@gmail.com Centro Médico Nacional de Occidente, IMSS Nephrology Guadalajara, Jalisco Mexico *
Ma del Refugio Santisbais Beas cymichluna@gmail.com Centro Médico Nacional de Occidente, IMSS Nephrology Guadalajara, Jalisco Mexico -
Adriana Banda López cymichluna@gmail.com Centro Médico Nacional de Occidente, IMSS Nephrology Guadalajara, Jalisco Mexico -
Alfonso Cueto Manzano cymichluna@gmail.com Centro Médico Nacional de Occidente, IMSS Nephrology Guadalajara, Jalisco Mexico -
Moisés Cruz Landino cymichluna@gmail.com Centro Médico Nacional de Occidente, IMSS Nephrology Guadalajara, Jalisco Mexico -
Javier Israel Ruiz González cymichluna@gmail.com Centro Médico Nacional de Occidente, IMSS Nephrology Guadalajara, Jalisco Mexico -
Salvador Mendoza Cabrera cymichluna@gmail.com Centro Médico Nacional de Occidente, IMSS Nephrology Guadalajara, Jalisco Mexico -
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Infective endocarditis (IE) in hemodialysis (HD) patients is associated with high morbidity and mortality. Despite its clinical relevance, data on IE in HD patients in Mexico remains limited. The aim of this study was to determine the frequency of IE in chronic kidney disease patients on HD.

Retrospective, single-center study of 88 adult HD patients diagnosed with IE (native or prosthetic valve) based on modified Duke criteria, hospitalized between December 2018 and December 2023. Clinical, microbiological, and echocardiographic data were collected at diagnosis; patient mortality was assessed at hospital discharge.

Of the 163 chronic kidney disease patients on HD admitted during the study period, 88 (48.9% female, 51.1% male) were diagnosed with IE. Hypertension was the most common comorbidity (n=54, 61.4%), followed by diabetes mellitus (n=32, 36.4%) and atrial fibrillation (n=1, 1.1%). Bacteremia was present at diagnosis in 84 patients (95.5%). The most frequent vascular access type was non-tunneled catheter (n=52, 59.1%). The average vegetation length was 1.9 ± 0.87 cm. Cardiac surgery was performed in 51 patients (58%). Figure 1 table 1 represent the frequency of pathogens associated with IE and valvular involvement. In hospital mortality was reported in 34 patients (38.6%).

IE is a frequent and life-threatening complication in HD patients. High rates of bacteremia and non-tunneled catheter use were observed. It is interesting to note that the most frequent site of involvement in this population was the tricuspid valve, in contrast to other series where the most commonly was the mitral. Improved vascular access strategies and early detection are crucial to reduce mortality in this vulnerable population.

Kewords