Infection is an important cause of morbidity and mortality in
hemodialysis patients. These patients are frequently hospitalized for
infections. The objective of our study was to evaluate hospitalization rate for
infections and to determine risk factors for
infection-related hospitalizations of
hemodialysis patients in Kaunas region, Lithuania. Ambulatory case records of 533 patients with
end-stage renal disease, dialyzed in all
hemodialysis centers in Kaunas region during the period of 2001-2004, were analyzed. Data on patient's condition and routine laboratory tests were collected in November of 2001, 2002, and 2003. These patients then were followed up for the next 12 months in order to evaluate
infection-related hospitalization rate. All patients were considered new patients every year, and general analysis of three-year data was performed. Statistical analyses were carried out using SPSS (Statistical Package for Social Sciences) and STATISTICA. Univariate statistical analysis was performed comparing the groups of patients that were hospitalized because of
infections and were not hospitalized. Relative risk of
infection-related hospitalization was estimated using Cox regression evaluating the time to first
infection-related hospitalization. The unadjusted
infection-related hospitalization rate was 0.2 per patient a year (18% of all hospitalizations). The median length of
hospital stay for
infections was 11 days. Univariate statistical analysis showed a statistically significant association between
infection-related hospitalizations and diabetes (P=0.02); lower
hemoglobin (P<0.0001),
creatinine (P=0.045), and
albumin (P=0.01) concentrations; higher interdialytic
weight gain (P=0.01). Multivariate Cox regression analysis revealed that only
hemoglobin concentration (P<0.001, RR=0.96), interdialytic
weight gain (P=0.002, RR=1.38), and
creatinine level (P=0.02, RR=0.99) were important risk factors for
infection-related hospitalization. Relative risk of
infection-related hospitalization was 4.4 times greater when
hemoglobin concentration was less than 100 g/L (P<0.001) and 1.9 times greater when interdialytic
weight gain was more than 4% of
body weight (P=0.008). CONCLUSION. In Kaunas region,
infection-related hospitalizations accounted for 18% of all hospitalizations.
Anemia,
creatinine level, and interdialytic
weight gain were important risk factors for
infection-related hospitalization of
hemodialysis patients.