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Host Defenses and Infectious Complications in Maintenance Hemodialysis Patients

  • Chapter
Replacement of Renal Function by Dialysis

Abstract

Prior to the advent of chronic hemodialysis, infection was a frequent terminal or pre-terminal event in patients with end-stage renal disease (ESRD). With the development of chronic hemodialysis therapy, infectious complications still result in significant morbidity and mortality, with up to one-third of deaths being attributable to infections (1–5). Despite improvement in dialysis and medical therapies, infection continues to account for a significant proportion (15 to 20%) of deaths in the chronic dialysis population (6–8). While this increased risk of infection is due in part to the necessity of blood access, there are abnormalities of the immune system in ESRD patients which may contribute to their predilection for infectious complications. In this chapter, we will review the incidence and types of infectious complications which occur in patients undergoing chronic hemodialysis, as well as outline our current understanding of the immune status of the dialysis patient. It is important to emphasize that the vast majority of infections are due to commonly occurring organisms, not opportunistic or unusual organisms, and that repetitive exposure to infectious risk factors has a major influence on the types of infections observed.

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Authors
  1. William F. Keane
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  2. Michael F. Maddy
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Editors and Affiliations

  1. Nephrology Division, F. Edward Hébert School of Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD, USA

    John F. Maher M.D., FACP (Professor of Medicine, Director) (Professor of Medicine, Director)

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Keane, W.F., Maddy, M.F. (1989). Host Defenses and Infectious Complications in Maintenance Hemodialysis Patients. In: Maher, J.F. (eds) Replacement of Renal Function by Dialysis. Springer, Dordrecht. https://doi.org/10.1007/978-94-009-1087-4_41

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