Profile of Catheter-Related Infections in Hemodialysis Patients with Double Lumen Catheters at Dr. Reksodiwiryo Hospital, Padang
Keywords:
Chronic Kidney Disease, Hemodialysis, Catheter Infection
Abstract
Background: Hemodialysis (HD) is the primary therapy for patients with advanced-stage chronic kidney disease (CKD). Although effective, the use of double lumen catheters (CDL) as vascular access in HD carries a high risk of infection.
Objective: This study aims to identify the infection profile in CKD patients using CDL during hemodialysis at Dr. Reksodiwiryo Hospital in Padang.
Methods: This study employs a retrospective descriptive design involving 60 hemodialysis patients from May to July 2024. The variables analyzed include age, gender, etiology, clinical manifestations, catheter location, catheter duration, and hematological parameters (leukocytes), with catheter-related infections (CRI) as the main dependent variable.
Results: The results show that the majority of patients were under 60 years old (51.7%), and more than half (56.7%) used CDL for less than 8 weeks. CDL infections most frequently occurred in the right jugular vein access (90.0%) with fever and chills as the primary symptoms (53.3%).
Conclusion: Using CDL for less than 8 weeks is linked to a high infection rate, with fever and chills as common symptoms. Recommendations include strict aseptic techniques during catheter insertion, prophylactic antibiotics for high leukocyte levels, and early planning for arteriovenous fistula (AVF) to minimize complications from long-term catheter use.
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References
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25. Marik PE, Flemmer M, Harrison W. The risk of catheter-related bloodstream infection with femoral venous catheters as compared to subclavian and internal jugular venous catheters: a systematic review of the literature and meta-analysis. Crit Care Med. 2012;40(8):2479–85. doi:10.1097/ccm.0b013e318255d9bc
2. Himmelfarb J, Vanholder R, Mehrotra R, Tonelli M. The current and future landscape of dialysis. Nat Rev Nephrol. 2020 Oct 30;16(10):573–85. doi:10.1038/s41581-020-0315-4
3. Sangadji D, Aditiawardana A, Tjempakasari A, Alimsardjono L. Association between the biofilm of double-lumen catheter and blood culture in hemodialysis patients with suspected central line-associated bloodstream infection. Indones J Kidney Hypertens. 2020;3(1):18–25.
4. Xie Y, Bowe B, Mokdad AH, others. Analysis of the global burden of disease study highlights the global, regional, and national trends of chronic kidney disease epidemiology from 1990 to 2016. Kidney Int. 2018;94(3):567–81. doi:10.1016/j.kint.2018.04.011
5. Aydin Z, Gursu M, Uzun S, others. Placement of hemodialysis catheters with a technical, functional, and anatomical viewpoint. Int J Nephrol. 2012;2012:302826. doi:10.1155/2012/302826
6. Ribeiro R de CHM, Oliveira GASA de, Ribeiro DF, Cesarino CB, Martins MI, Oliveira SA da C. Survey about infection at the site of a double-lumen catheter insertion. Acta Paul Enferm. 2008;21(special issue):212–5. doi:10.1590/s0103-21002008000500014
7. Schwab SJ, Beathard GA. The hemodialysis catheter conundrum: hate living with them, but can’t live without them. Kidney Int. 1999;56(1):1–17. doi:10.1046/j.1523-1755.1999.00512.x
8. Saran R, Li Y, Robinson B, others. US renal data system 2015 annual data report: epidemiology of kidney disease in the United States. Am J Ki. 2016;67(3 Suppl 1):S1--S305. doi:10.1053/j.ajkd.2015.12.014
9. Basri NS, Patrianef. Infection of double lumen catheter as hemodialysis access. New Ropanasuri J Surg [Internet]. 2017;2(1):25–8. Available from: https://scholarhub.ui.ac.id/nrjs/vol2/iss1/doi:10.7454/nrjs.v2i1.18
10. Arub L, Siyam N. Chronic kidney disease incidence in hypertension patients. J Public Heal Res Dev. 2024;8(1):63–73. doi:10.15294/higeia.v8i1.68655
11. Weldetensae MK, Migbnesh Geberemedhin Weledegebriel, Nigusse AT, Ephrem Berhe, Gebrearegay H. Catheter-related blood stream infections and associated factors among hemodialysis patients in a tertiary care hospital. Infect Drug Resist. 2023;16:3145–56. doi:10.2147/idr.s409400
12. Mermel LA. Prevention of intravascular catheter-related infections. Ann Intern Med. 2000;132(5):391–402. doi:10.7326/0003-4819-132-5-200003070-00009
13. Kemas MD, Fahmi JY, Abdul R, Ifan R, Wahyu S. Characteristic of catheter double lumen infection in chronic kidney disease patients at Dr. Mohammad Hoesin Hospital Palembang. Contag Sci Period Public Heal. 2023;5(2):451–61. doi:10.30829/contagion.v5i2.15203
14. Gupta S, Mallya SP, Bhat A, Baliga S. Microbiology of non-tunnelled catheter-related infections. J Clin Diagn Res. 2016;10(7):DC24--DC28. doi:10.7860/jcdr/2016/19058.8155
15. Smith J, Brown L. Immune function and comorbidities in elderly CKD patients. J Geriatr Nephrol. 2020;12(3):210–20.
16. Hajji M, Neji M, Agrebi S, Ben Nessira S, Ben Hamida F, Barbouch, et al. Incidence and challenges in management of hemodialysis catheter-related infections. Sci Rep. 2022;12(1):20536. doi:10.1038/s41598-022-23787-5
17. Williams M, Smith J. Hypertension and its role in chronic kidney disease progression. KDOQI Clinical Practice Guidelines for Hypertension and Cardiovascular Disease in Dialysis Patients. Am J Hypertens [Internet]. 2021;34(6):550–9. Available from: https://www.kidney.org/professionals/professionals/professionals/kdoqi
18. Brown JL, Schram MT. The impact of diabetes mellitus on infection risk in elderly patients. J Diabetes Res. 2020;Article ID 6785923.
19. Iqbal M, Rustam R, Rivaldy V. Risk factors of catheter-related infection in patients undergoing hemodialysis using double lumen catheter at Dr. M. Djamil Hospital Padang. Biosci Med J Biomed Transl Res. 2021;6(1):1292–9. doi:10.37275/bsm.v6i1.436
20. Dinarello CA. Historical review of cytokines as mediators of fever and inflammation. J Infect Dis. 2004;190(3):362–70.
21. Rhee C, Klompas M. Sepsis as a preventable complication. JAMA Netw Open. 2020;3(4):e202918.
22. Pitiriga V, Giannitsioti E, Nikolopoulou A, Tsakris A. Duration of central venous catheter placement and central line-associated bloodstream infections after the adoption of prevention bundles: A two-year retrospective study. Antimicrob Resist Infect Control. 2022;11(1):96. doi:10.1186/s13756-022-01131-w
23. Lok CE, Huber TS, Lee T, Shenoy S, Yevzlin AS, Abreo K, et al. KDOQI clinical practice guideline for vascular access : 2019 update. Am J Kidney Dis. 2020;75(4 Suppl 2):S1–164. doi:10.1053/j.ajkd.2019.12.001
24. O’Grady NP, Alexander M, Burns LA, Dellinger EP, Garland J, Heard SO, et al. Guidelines for the prevention of intravascular catheter-related infections. Clin Infect. 2011 May;52(9):e162-93. doi:10.1093/cid/cir257
25. Marik PE, Flemmer M, Harrison W. The risk of catheter-related bloodstream infection with femoral venous catheters as compared to subclavian and internal jugular venous catheters: a systematic review of the literature and meta-analysis. Crit Care Med. 2012;40(8):2479–85. doi:10.1097/ccm.0b013e318255d9bc
Published
2025-08-24
How to Cite
1.
Putra M, Vidiansyah A, Veronike E, Harun H. Profile of Catheter-Related Infections in Hemodialysis Patients with Double Lumen Catheters at Dr. Reksodiwiryo Hospital, Padang. inakidney [Internet]. 24Aug.2025 [cited 5Mar.2026];2(2):55-2. Available from: https://inakidneyhypertension.co.id/index.php/inakidney/article/view/189
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