Haemodialysis catheter-related infection: time for action

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Abstract
Central venous catheters were a major advance in end-stage renal disease (ESRD) patient care until the burden of catheter-related complications became obvious. Catheter-related infection is one of the major causes of morbidity, with potential lethal hazards in haemodialysis patients. Today, the incidence of bacteraemia ranges from 0.5 to 13 per 1000 patient-days with haemodialysis catheters. Lower rates are observed with permanent silicone catheters (cuffed or non-cuffed) and higher ones with temporary polyurethane catheters. In a recent multicentre prospective study involving 988 ESRD patients it has been estimated that the relative risk of bacteraemia was 7.64-fold higher in patients requiring catheters (n=58; 5.9%) as compared to those having a native arteriovenous fistula [1]. In order to reduce infections related to the use of haemodialysis catheter, it is time to address the following issues: first, evaluating the burden; second, defining infection-related catheters; third, identifying risk factors; fourth, making recommendations and looking at new technical solutions.