Frontiers in medicine · 2026
Infectious disease outcomes in end-stage renal disease: the influence of dialysis type on patient vulnerability in Hail region.
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Akasha Rihab, Binsaleh Naif K, Abdalla Randa Abdeen Husien, Suliman Obey, Abuqurayn Ibrahim Nasser, Alouffi Sultan
Аннотация
BACKGROUND: Infections are a major threat to patients with end-stage renal disease (ESRD) receiving renal replacement therapy. Hemodialysis (HD) and peritoneal dialysis (PD) differ in access type, exposure to healthcare environments, and infection pathways, leading to distinct risks for catheter-related bloodstream infection (CRBSI), peritonitis, hospitalization, and adverse outcomes. Recognizing local patterns is essential for prevention planning and quality improvement.
AIM: To compare dialysis-related infection prevalence, microbiological profiles, hospitalization events, and biochemical factors between HD and PD patients over a 3-year period (2023-2025) in a predominantly Saudi tertiary dialysis cohort, while describing overall documented infections and non-dialysis infection subtypes as secondary outcomes, and to identify potential infection risk factors relevant to local dialysis practice.
RESULTS: HD patients were older and had higher rates of diabetes and hypertension. Infection frequency was 18% in HD and 9% in PD. HD patients had higher incident rates of bloodstream infection, most of them catheter-related, whereas PD patients had higher peritonitis incidence. Infection-related hospitalization was higher in HD (12% vs. 6%), and CRP concentrations were higher in the period of infection. HD had a higher prevalence of Staphylococcus aureus, whereas Staphylococcus epidermidis was more prevalent in PD. Rates of infections decreased slightly in the study period.
CONCLUSION: HD patients had higher infection burden and more severe outcomes compared to PD patients. Prevention strategies specific to the modality, high-profile monitoring and high-performance quality improvement programs targeted to specific dialysis populations are required to reduce the complications arising from infection.
AIM: To compare dialysis-related infection prevalence, microbiological profiles, hospitalization events, and biochemical factors between HD and PD patients over a 3-year period (2023-2025) in a predominantly Saudi tertiary dialysis cohort, while describing overall documented infections and non-dialysis infection subtypes as secondary outcomes, and to identify potential infection risk factors relevant to local dialysis practice.
RESULTS: HD patients were older and had higher rates of diabetes and hypertension. Infection frequency was 18% in HD and 9% in PD. HD patients had higher incident rates of bloodstream infection, most of them catheter-related, whereas PD patients had higher peritonitis incidence. Infection-related hospitalization was higher in HD (12% vs. 6%), and CRP concentrations were higher in the period of infection. HD had a higher prevalence of Staphylococcus aureus, whereas Staphylococcus epidermidis was more prevalent in PD. Rates of infections decreased slightly in the study period.
CONCLUSION: HD patients had higher infection burden and more severe outcomes compared to PD patients. Prevention strategies specific to the modality, high-profile monitoring and high-performance quality improvement programs targeted to specific dialysis populations are required to reduce the complications arising from infection.