Skip to main content
SpringerLink
Log in

Infective Endocarditis in Special Populations: Patients Under Dialysis

  • Chapter
  • First Online:
Infective Endocarditis

  • 1726 Accesses

Abstract

Incidence of infective endocarditis (IE) is estimated to be around 70 times higher in haemodialysis (HD) patients than in the general population and HD patients represent from 2 to 35 % of the series of IE, being more frequent in the US than in the European countries. Many characteristics of HD patients favour health-care related infection and development of IE, such as diabetes and degenerative calcified valvular diseases. Among different types of vascular access, central venous catheter (CVC) is related to the highest risk of bacteremia. In case of Staphylococcus aureus bacteremia, which are the most frequent bacteremia among HD patients, or in case of bacteremia due to other micro-organisms potentially responsible for IE, echocardiography must systematically be performed to diagnose a potential IE reported to complicate bacteremia in around 15 % of the cases. Treatment of IE includes antibiotic therapy, cardiac surgery if needed -and in that case, bioprosthesis seems to be the most appropriate substitute- and treatment of portal of entry with potential removal and replacement of CVC when appropriate. However, the prognosis of IE among HD patients is dramatically poor. So, all the efforts should be made to avoid bloodstream infection in HD patients by preferring arteriovenous fistula to CVC when possible and by emphasizing the importance of aseptic measures during HD.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 129.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 169.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 169.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Abbreviations

CKD:

Chronic kidney disease

CVC:

Central venous catheter

ESRD:

End-stage renal disease

HD:

Haemodialysis

ICD:

Implantable Cardioverter Defibrillator

IE:

Infective endocarditis

PD:

Peritoneal dialysis

S.aureus :

Staphylococcus aureus

References

  1. Noordzij M, Kramer A, Abad Diez JM, Alonso de laTorre R, Arcos Fuster E, Bikbov BT, et al. Renal replacement therapy in Europe: a summary of the 2011 ERA-EDTA Registry Annual Report. Clin Kidney J. 2014;7(2):227–38.

    Article  PubMed  PubMed Central  Google Scholar 

  2. Nucifora G, Badano LP, Viale P, Gianfagna P, Allocca G, Montanaro D, et al. Infective endocarditis in chronic haemodialysis patients: an increasing clinical challenge. Eur Heart J. 2007;28(19):2307–12.

    Article  PubMed  Google Scholar 

  3. Aslam S, Vaida F, Ritter M, Mehta RL. Systematic review and meta-analysis on management of hemodialysis catheter-related bacteremia. J Am Soc Nephrol. 2014;25(12):2927–41.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  4. Blagg CR, Hickman RO, Eschbach JW, Scribner BH. Home hemodialysis: six years’ experience. N Engl J Med. 1970;283:1126–31.

    Article  CAS  PubMed  Google Scholar 

  5. Murdoch DR, Corey GR, Hoen B, Miro JM, Fowler VG, Bayer AS, et al. Clinical presentation, etiology, and outcome of infective endocarditis in the 21st century: the International Collaboration on Endocarditis-Prospective Cohort Study. Arch Intern Med. 2009;169(5):463–73.

    Article  PubMed  PubMed Central  Google Scholar 

  6. Cabell CH, Jollis JG, Peterson GE, Corey GR, Anderson DJ, Sexton DJ, et al. Changing patient characteristics and the effect on mortality in endocarditis. Arch Intern Med. 2002;162(1):90–4.

    Article  PubMed  Google Scholar 

  7. Selton-Suty C, Celard M, Le Moing V, Doco-Lecompte T, Chirouze C, Iung B, et al. Preeminence of Staphylococcus aureus in infective endocarditis: a 1-year population-based survey. Clin Infect Dis. 2012;54(9):1230–9.

    Article  PubMed  Google Scholar 

  8. Hoen B, Alla F, Béguinot I, Bouvet A, Briancon S, Casalta JP, et al. Changing profile of infective endocarditis – results of a one-year survey in France in 1999. JAMA. 2002;288(1):75–81.

    Article  PubMed  Google Scholar 

  9. Abbott KC, Agodoa LY. Hospitalizations for bacterial endocarditis after initiation of chronic dialysis in the United States. Nephron. 2002;91(2):203–9.

    Article  PubMed  Google Scholar 

  10. Wray D, Steed L, Singleton C, Church P, Cantey JR, Gomez J. Impact of regional comorbidity on infective endocarditis in a southeastern United States medical center. Am J Med Sci. 2010;340(6):439–47.

    Article  PubMed  Google Scholar 

  11. Ruiz M, Sanchez MP, Dominguez JC, Pineda SO, Penas ER, Rubio MD, et al. Infective endocarditis in patients receiving chronic hemodialysis: clinical features and outcome. J Heart Valve Dis. 2005;14(1):11–4.

    PubMed  Google Scholar 

  12. Goodkin DA, Robinson BM. Fistula versus catheter outcomes: the importance of surgical training. Kidney Int. 2013;83(3):531–2.

    Article  PubMed  Google Scholar 

  13. Goodkin DA, Bragg-Gresham JL, Koenig KG, Wolfe RA, Akiba T, Andreucci VE, et al. Association of comorbid conditions and mortality in hemodialysis patients in Europe, Japan, and the United States: the Dialysis Outcomes and Practice Patterns Study (DOPPS). J Am Soc Nephrol. 2003;14(12):3270–7.

    Article  PubMed  Google Scholar 

  14. Engemann JJ, Friedman JY, Reed SD, Griffiths RI, Szczech LA, Kaye KS, et al. Clinical outcomes and costs due to Staphylococcus aureus bacteremia among patients receiving long-term hemodialysis. Infect Control Hosp Epidemiol. 2005;26(6):534–9.

    Article  PubMed  Google Scholar 

  15. Le Moing V, Alla F, Doco-Lecompte T, Delahaye F, Piroth L, Chirouze C, et al. Staphylococcus aureus bloodstream infection and endocarditis – A prospective cohort study. PLoS One. 2015;10(5):e0127385.

    Article  PubMed  PubMed Central  Google Scholar 

  16. Hoen B, Paul-Dauphin A, Hestin D, Kessler M. EPIBACDIAL: a multicenter prospective study of risk factors for bacteremia in chronic hemodialysis patients. J Am Soc Nephrol. 1998;9(5):869–76.

    CAS  PubMed  Google Scholar 

  17. Powe NR, Jaar B, Furth SL, Hermann J, Briggs W. Septicemia in dialysis patients: incidence, risk factors, and prognosis. Kidney Int. 1999;55(3):1081–90.

    Article  CAS  PubMed  Google Scholar 

  18. Rhee CM, Leung AM, Kovesdy CP, Lynch KE, Brent GA, Kalantar-Zadeh K. Updates on the management of diabetes in dialysis patients. Semin Dial. 2014;27(2):135–45.

    Article  PubMed  PubMed Central  Google Scholar 

  19. Fox CS, Larson MG, Vasan RS, Guo CY, Parise H, Levy D, et al. Cross-sectional association of kidney function with valvular and annular calcification: the Framingham heart study. J Am Soc Nephrol. 2006;17(2):521–7.

    Article  PubMed  Google Scholar 

  20. Choi MJ, Kim JK, Kim SG, Kim SE, Kim SJ, Kim HJ, et al. Association between cardiac valvular calcification and myocardial ischemia in asymptomatic high-risk patients with end-stage renal disease. Atherosclerosis. 2013;229(2):369–73.

    Article  CAS  PubMed  Google Scholar 

  21. Ikee R, Honda K, Ishioka K, Oka M, Maesato K, Moriya H, et al. Differences in associated factors between aortic and mitral valve calcification in hemodialysis. Hypertens Res. 2010;33(6):622–6.

    Article  CAS  PubMed  Google Scholar 

  22. Leskinen Y, Paana T, Saha H, Groundstroem K, Lehtimaki T, Kilpinen S, et al. Valvular calcification and its relationship to atherosclerosis in chronic kidney disease. J Heart Valve Dis. 2009;18(4):429–38.

    PubMed  Google Scholar 

  23. Sharma R, Pellerin D, Gaze DC, Mehta RL, Gregson H, Streather CP, et al. Mitral annular calcification predicts mortality and coronary artery disease in end stage renal disease. Atherosclerosis. 2007;191(2):348–54.

    Article  CAS  PubMed  Google Scholar 

  24. Raggi P, Boulay A, Chasan-Taber S, Amin N, Dillon M, Burke SK, et al. Cardiac calcification in adult hemodialysis patients. A link between end-stage renal disease and cardiovascular disease? J Am Coll Cardiol. 2002;39(4):695–701.

    Article  PubMed  Google Scholar 

  25. Ribeiro S, Ramos A, Brandao A, Rebelo JR, Guerra A, Resina C, et al. Cardiac valve calcification in haemodialysis patients: role of calcium-phosphate metabolism. Nephrol Dial Transplant. 1998;13(8):2037–40.

    Article  CAS  PubMed  Google Scholar 

  26. Moe SM, Drüeke TB, Block GA, Cannata-Andía JB, Elder GJ, Fukagawa M, et al. KDIGO clinical practice guideline for the diagnosis, evaluation, prevention, and treatment of Chronic Kidney Disease-Mineral and Bone Disorder (CKD-MBD). Kidney Int Suppl. 2009;113:S1–130.

    Google Scholar 

  27. Chang CF, Kuo BI, Chen TL, Yang WC, Lee SD, Lin CC. Infective endocarditis in maintenance hemodialysis patients: fifteen years’ experience in one medical center. J Nephrol. 2004;17(2):228–35.

    PubMed  Google Scholar 

  28. Santoro D, Benedetto F, Mondello P, Pipito N, Barilla D, Spinelli F, et al. Vascular access for hemodialysis: current perspectives. Int J Nephrol Renovasc Dis. 2014;7:281–94.

    Article  PubMed  PubMed Central  Google Scholar 

  29. Taylor G, Gravel D, Johnston L, Embil J, Holton D, Paton S. Prospective surveillance for primary bloodstream infections occurring in Canadian hemodialysis units. Infect Control Hosp Epidemiol. 2002;23(12):716–20.

    Article  PubMed  Google Scholar 

  30. Marr KA, Kong L, Fowler VG, Gopal A, Sexton DJ, Conlon PJ, et al. Incidence and outcome of Staphylococcus aureus bacteremia in hemodialysis patients. Kidney Int. 1998;54(5):1684–9.

    Article  CAS  PubMed  Google Scholar 

  31. Liang SY, Marschall J. Update on emerging infections: news from the Centers for Disease Control and Prevention. Vital signs: central line-associated blood stream infections–United States, 2001, 2008, and 2009. Ann Emerg Med. 2011;58:447–51.

    Google Scholar 

  32. Grothe C, da Silva Belasco AG, de Cassia Bittencourt AR, Vianna LA, de Castro Cintra SR, Barbosa DA. Incidence of bloodstream infection among patients on hemodialysis by central venous catheter. Rev Lat Am Enfermagem. 2010;18(1):73–80.

    Article  PubMed  Google Scholar 

  33. Maraj S, Jacobs LE, Maraj R, Kotler MN. Bacteremia and infective endocarditis in patients on hemodialysis. Am J Med Sci. 2004;327(5):242–9.

    Article  PubMed  Google Scholar 

  34. Nielsen LH, Jensen-Fangel S, Benfield T, Skov R, Jespersen B, Larsen AR, et al. Risk and prognosis of Staphylococcus aureus bacteremia among individuals with and without end-stage renal disease: a Danish, population-based cohort study. BMC Infect Dis. 2015;15(1):6.

    Article  PubMed  PubMed Central  Google Scholar 

  35. Fowler Jr VG, McIntyre LM, Yeaman MR, Peterson GE, Barth RL, Corey GR, et al. In vitro resistance to thrombin-induced platelet microbicidal protein in isolates of Staphylococcus aureus from endocarditis patients correlates with an intravascular device source. J Infect Dis. 2000;182(4):1251–4.

    Article  CAS  PubMed  Google Scholar 

  36. Spies C, Madison JR, Schatz IJ. Infective endocarditis in patients with end-stage renal disease: clinical presentation and outcome. Arch Intern Med. 2004;164(1):71–5.

    Article  PubMed  Google Scholar 

  37. Nori US, Manoharan A, Thornby JI, Yee J, Parasuraman R, Ramanathan V. Mortality risk factors in chronic haemodialysis patients with infective endocarditis. Nephrol Dial Transplant. 2006;21(8):2184–90.

    Article  PubMed  Google Scholar 

  38. Nguyen DB, Lessa FC, Belflower R, Mu Y, Wise M, Nadle J, et al. Invasive methicillin-resistant Staphylococcus aureus infections among patients on chronic dialysis in the United States, 2005–2011. Clin Infect Dis. 2013;57(10):1393–400.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  39. Lewis SS, Sexton DJ. Metastatic complications of bloodstream infections in hemodialysis patients. Semin Dial. 2013;26(1):47–53.

    Article  PubMed  Google Scholar 

  40. Habib G, Hoen B, Tornos P, Thuny F, Prendergast B, Vilacosta I, et al. Guidelines on the prevention, diagnosis, and treatment of infective endocarditis (new version 2009): the Task Force on the Prevention, Diagnosis, and Treatment of Infective Endocarditis of the European Society of Cardiology (ESC). Endorsed by the European Society of Clinical Microbiology and Infectious Diseases (ESCMID) and the International Society of Chemotherapy (ISC) for Infection and Cancer. Eur Heart J. 2009;30(19):2369–413.

    Article  PubMed  Google Scholar 

  41. Mermel LA, Allon M, Bouza E, Craven DE, Flynn P, O’Grady NP, et al. Clinical practice guidelines for the diagnosis and management of intravascular catheter-related infection: 2009 update by the Infectious Diseases Society of America. Clin Infect Dis. 2009;49(1):1–45.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  42. Bianchi G, Solinas M, Bevilacqua S, Glauber M. Are bioprostheses associated with better outcome than mechanical valves in patients with chronic kidney disease requiring dialysis who undergo valve surgery? Interact Cardiovasc Thorac Surg. 2012;15(3):473–83.

    Article  PubMed  PubMed Central  Google Scholar 

  43. Leither MD, Shroff GR, Ding S, Gilbertson DT, Herzog CA. Long-term survival of dialysis patients with bacterial endocarditis undergoing valvular replacement surgery in the United States. Circulation. 2013;128(4):344–51.

    Article  PubMed  Google Scholar 

  44. Kamalakannan D, Pai RM, Johnson LB, Gardin JM, Saravolatz LD. Epidemiology and clinical outcomes of infective endocarditis in hemodialysis patients. Ann Thorac Surg. 2007;83(6):2081–6.

    Article  PubMed  Google Scholar 

  45. Fernandez-Cean J, Alvarez A, Burguez S, Baldovinos G, Larre-Borges P, Cha M. Infective endocarditis in chronic haemodialysis: two treatment strategies. Nephrol Dial Transplant. 2002;17(12):2226–30.

    Article  CAS  PubMed  Google Scholar 

  46. Gallieni M, Brenna I, Brunini F, Mezzina N, Pasho S, Giordano A. Dialysis central venous catheter types and performance. J Vasc Access. 2014;15 Suppl 7:S140–6.

    Article  PubMed  Google Scholar 

  47. Gupta N, Cannon M, Srinivasan A. National agenda for prevention of healthcare-associated infections in dialysis centers. Semin Dial. 2013;26(4):376–83.

    Article  PubMed  Google Scholar 

  48. Silva TN, de Marchi D, Mendes P, Ponce D, Silva TN. Approach to prophylactic measures for central venous catheter-related infections in hemodialysis: a critical review. Hemodial Int. 2014;18(1):15–23.

    Article  PubMed  Google Scholar 

  49. Niyyar VD, Lok CE. Pros and cons of catheter lock solutions. Curr Opin Nephrol Hypertens. 2013;22(6):669–74.

    Article  PubMed  Google Scholar 

  50. Badve SV, Johnson DW. Chronic kidney disease: haemodialysis catheter care in practice. Nat Rev Nephrol. 2014;10(3):131–3.

    Article  CAS  PubMed  Google Scholar 

  51. Fattom A, Matalon A, Buerkert J, Taylor K, Damaso S, Boutriau D. Efficacy profile of a bivalent Staphylococcus aureus glycoconjugated vaccine in adults on hemodialysis: phase III randomized study. Hum Vaccin Immunother. 2015;11(3):632–41.

    Article  PubMed  PubMed Central  Google Scholar 

  52. Shinefield H, Black S, Fattom A, Horwith G, Rasgon S, Ordonez J, et al. Use of a Staphylococcus aureus conjugate vaccine in patients receiving hemodialysis. N Engl J Med. 2002;346(7):491–6.

    Article  PubMed  Google Scholar 

  53. Jansen KU, Girgenti DQ, Scully IL, Anderson AS. Vaccine review: “Staphyloccocus aureus vaccines: problems and prospects”. Vaccine. 2013;31(25):2723–30.

    Article  CAS  PubMed  Google Scholar 

  54. Robinson DL, Fowler VG, Sexton DJ, Corey RG, Conlon PJ. Bacterial endocarditis in hemodialysis patients. Am J Kidney Dis. 1997;30(4):521–4.

    Article  CAS  PubMed  Google Scholar 

  55. McCarthy JT, Steckelberg JM. Infective endocarditis in patients receiving long-term hemodialysis. Mayo Clin Proc. 2000;75(10):1008–14.

    Article  CAS  PubMed  Google Scholar 

  56. Maraj S, Jacobs LE, Kung SC, Raja R, Krishnasamy P, Maraj R, et al. Epidemiology and outcome of infective endocarditis in hemodialysis patients. Am J Med Sci. 2002;324(5):254–60.

    Article  PubMed  Google Scholar 

  57. Doulton T, Sabharwal N, Cairns HS, Schelenz S, Eykyn S, O’Donnell P, et al. Infective endocarditis in dialysis patients: new challenges and old. Kidney Int. 2003;64(2):720–7.

    Article  PubMed  Google Scholar 

  58. Jones DA, McGill LA, Rathod KS, Matthews K, Gallagher S, Uppal R, et al. Characteristics and outcomes of dialysis patients with infective endocarditis. Nephron Clin Pract. 2013;123(3–4):151–6.

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Cardiology, University Hospital of Nancy, Institut Lorrain du Coeur et des Vaisseaux, Vandoeuvre les Nancy, France

    Christine Selton-Suty MD

  2. Department of Cardiology, University Hospital of Nancy, Vandoeuvre les Nancy, France

    Olivier Huttin MD

  3. Department of Infectious and Tropical Diseases, University Hospital of Nancy, Vandoeuvre les Nancy, France

    François Goehringer MD

  4. Department of Nephrology, University Hospital of Nancy, Vandoeuvre les Nancy, France

    Luc Frimat MD, PhD

Authors
  1. Christine Selton-Suty MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Olivier Huttin MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. François Goehringer MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Luc Frimat MD, PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Christine Selton-Suty MD .

Editor information

Editors and Affiliations

  1. Cardiology Department, Hôpital La Timone, Marseille, France

    Gilbert Habib

Rights and permissions

Reprints and permissions

Copyright information

© 2016 Springer International Publishing Switzerland

About this chapter

Cite this chapter

Selton-Suty, C., Huttin, O., Goehringer, F., Frimat, L. (2016). Infective Endocarditis in Special Populations: Patients Under Dialysis. In: Habib, G. (eds) Infective Endocarditis. Springer, Cham. https://doi.org/10.1007/978-3-319-32432-6_19

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-32432-6_19

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-32430-2

  • Online ISBN: 978-3-319-32432-6

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation