Abstract 12011: Risk of Infective Endocarditis in Patients Receiving Chronic Renal Replacement Therapy - a Nationwide Study
Introduction: Infective endocarditis (IE) is a serious complication in patients receiving chronic renal replacement therapy (RRT), and renal failure is a well-known prognostic factor indicating a poor outcome in IE. We compared occurrence and risk factors of IE in nationwide cohort of patients with end-stage renal failure treated with haemodialysis (HD), peritoneal dialysis (PD) and kidney transplantation (KT) respectively.
Methods: In total 10,612 patients initiated renal replacement therapy in the period from January 1st, 1996 to December 31st, 2012. The primary treatment modality, HD, PD or KT and changes during follow-up were identified. IE was identified in the Danish Patient Registry and risk and incidence rates were calculated according to the time interval in the various treatment modalities. Risk factors for IE were analyzed in multivariable Cox regression analysis according to renal replacement treatment modality.
Results: The overall incidence rate of IE was 314.4/100,000 person-years in patients receiving RRT. The incidence rate was highest in patients receiving HD 594.2/100,000 person-years, for PD 75.8/100,000 person-years and for KT 57.6/100,000 person-years. The adjusted Cox regression analysis found hazard ratio (HR) for IE in HD patients of 5.14 (95% CI 3.13-8.42) and 0.41 (95% CI 0.19-0.88) for the KT recipients, respectively, compared to patients in PD. Previous valvular disease, diabetes and previous IE were significant risk factors of IE, (Fig.).
Conclusion: Patients receiving renal replacement therapy have a high incidence of IE, in particular during treatment with HD. Heart valve disease, diabetes- and previous IE prior to start of renal replacement therapy are significant risk factors for developing subsequent IE.
Author Disclosures: M.S. Chaudry: None. G. Gislason: None. A. Kamper: None. M. Rix: None. N.E. Bruun: None.
- © 2014 by American Heart Association, Inc.