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Infection prevention in home dialysis
Muthana Al Sahlawi1, Christopher T Chan2,3, Jeffrey Perl4
1Department of Internal Medicine, College of Medicine, King Faisal University, Al-Hasa, Saudi Arabia.
Current Opinion in Nephrology and Hypertension
|November 5, 2024
Summary
Patient education is key to preventing infections in home dialysis (peritoneal dialysis and home hemodialysis). Managing risk factors and proper training significantly reduce infection rates, improving patient outcomes.
Area of Science:
- Nephrology
- Infectious Disease Prevention
- Patient Care
Background:
- Home dialysis (peritoneal dialysis, PD; home hemodialysis, HHD) offers benefits over in-center hemodialysis (HD).
- Infection is a critical concern for patients with kidney failure undergoing dialysis.
- Preventing dialysis and access-related infections is paramount for patient safety and outcomes.
Purpose of the Study:
- To review evidence-based strategies for infection prevention in home dialysis patients.
- To emphasize measures targeting dialysis and access-related infections.
Main Methods:
- Narrative review of existing literature.
- Focus on infection prevention in PD and HHD modalities.
Main Results:
- Comprehensive patient and care partner education is crucial for infection prevention.
- In PD, managing risk factors (hypokalemia, constipation, pets) and using prophylaxis reduces peritonitis.
- In HHD, minimizing central venous catheter (CVC) use and duration prevents bloodstream infections.
- For arteriovenous fistula cannulation, rope ladder technique is safer than buttonhole.
Conclusions:
- Structured, evidence-based patient training programs are essential in home dialysis units.
- Kidney care providers must understand home dialysis infection risks.
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