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Pyogenic liver abscess in ESRD patients undergoing maintenance dialysis therapy.
Ya-Fei Yang1, Huang-Joe Wang, Wei-Chih Kan
1Division of Nephrology and Cardiology, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan.
Summary
Pyogenic liver abscess is rare in patients with end-stage renal disease (ESRD) on dialysis but carries a high mortality rate. Early recognition and management are crucial for this vulnerable population.
Area of Science:
- Nephrology
- Infectious Diseases
- Hepatology
Background:
- Patients with end-stage renal disease (ESRD) undergoing dialysis exhibit heightened susceptibility to bacterial infections.
- Data on pyogenic liver abscess (PLA) in this specific patient demographic are notably scarce.
Purpose of the Study:
- To investigate the incidence, clinical characteristics, and outcomes of pyogenic liver abscess in patients with end-stage renal disease on maintenance dialysis therapy.
Main Methods:
- A retrospective analysis was conducted on patients with ESRD and PLA across two tertiary referral centers.
- Medical records from January 1995 to September 2004 were reviewed for demographic, clinical, microbiological, and outcome data.
Main Results:
- Twenty-seven cases of PLA were identified among 20,676 ESRD patients on dialysis, with diabetes mellitus being a major predisposing factor.
- Klebsiella pneumoniae was the most common pathogen; fever and chills were the predominant symptoms.
- The overall in-hospital mortality rate was 33.3%, with no significant difference in mortality between patients who underwent invasive procedures and those who did not.
Conclusions:
- Pyogenic liver abscess, while uncommon, represents a serious condition with significant mortality in patients with ESRD on dialysis.
- The findings underscore the importance of considering PLA in the differential diagnosis of infections in this patient group.