Outcomes of End Stage Renal Disease in Patients With Infective Endocarditis: A Nationwide Population-Based Study

Infective endocarditis (IE) is a serious and potentially lethal condition in patients with end-stage renal disease (ESRD). This study aimed to describe the clinical features, provide epidemiology information, and compare short and long-term outcomes of IE in patients with ESRD.

Patients who were admitted due to IE from 2001 to 2021 were identified from Taiwan's National Health Insurance Research Database and grouped based on whether they were undergoing chronic dialysis with ESRD. Primary outcomes were surgical rate during the index IE hospitalization, in-hospital death, and all-cause death after surviving to discharge.

A total of 27 336 patients were included, with 3258 (11.9%) receiving dialysis. The surgical rate significantly increased over years in both the groups with and without ESRD. In-hospital and late mortalities were significantly higher in patients with ESRD (32.9% versus 16.9%, and 76.0% versus 48.1%, respectively). The predominant pathogen was methicillin-resistant Staphylococcus aureus, significantly higher in patients with ESRD (56.7% versus 32.8%). The vintage, type of hemodialysis access (tunnels, grafts, or fistulas), and initial dialysis modality were not correlated to the risk of in-hospital mortality of patients with IE with ESRD. Patients who received valve surgery had better long-term survival than those who did not receive in either the groups with and without ESRD and non-ESRD.

Patients with ESRD have higher in-hospital and late mortality rates, more complications, and a higher recurrence rate of IE than patients without ESRD. The long-term survival rates were higher in both the groups with and without ESRD and non-ESRD who underwent surgeries for IE; therefore, surgery may be considered if the patient's condition permits.