Conversion from Intermittent Hemodialysis to Peritoneal Dialysis in Metastatic Catheter-Related Bloodstream Infection

Of all complications from central venous catheters (CVC) in end-stage renal disease (ESRD) patients, catheter-related bloodstream infection (CRBSI) is one of the most devastating consequences. The option of catheter salvage is not an effective measure with metastatic infections. However, in patients...

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Published in:Case reports in nephrology and dialysis 2023-01, Vol.13 (1), p.97-103
Main Authors: Ghandour, Mohamedanwar, Thimmisetty, Ravi K., Sondheimer, James, Imran, Nashat, Bhat, Zeenat Y., Osman-Malik, Yahya Mohamed
Format: Article
Language:English
Subjects:
acute kidney injury
Antibiotics
Biofilms
Case reports
catheter-related bloodstream infection
Catheters
emergency department
end-stage renal disease
Erythema
Fever
Hemodialysis
Hemodynamics
Hypertension
intensive care unit
intermittent hemodialysis
Lifesaving
Metastasis
Microorganisms
Mortality
Nosocomial infections
Patients
Peritoneal dialysis
renal replacement therapy
Single Case
Staphylococcus infections
Thrombosis
Venous access
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Summary:Of all complications from central venous catheters (CVC) in end-stage renal disease (ESRD) patients, catheter-related bloodstream infection (CRBSI) is one of the most devastating consequences. The option of catheter salvage is not an effective measure with metastatic infections. However, in patients with severe vasculopathy and/or near end-stage vascular disease, preservation of the venous access should be given utmost importance as the luxury of utilizing another vascular site is markedly limited. Providing adequate renal replacement therapy in this group of patients can be remarkably challenging for nephrologists. We are presenting an ESRD patient with advanced vascular disease who developed metastatic CRBSI with worsening uremia who was successfully converted from intermittent hemodialysis (IHD) to peritoneal dialysis (PD). Our rationale was to minimize repeated intravascular procedures coupled with the presence of another intravascular device. This has led to a complete resolution of persistent bacteremia, with a steady improvement in the uremic state. Conversion from IHD to PD for persistent bacteremia with metastatic complications was seldom addressed in literature. In the absence of a significant contraindication to PD, it can be considered as a valid alternative possibility in order to interrupt this viscous cycle, especially in vasculopathic patients.
ISSN:2296-9705
2296-9705
DOI:10.1159/000531094