Sociodemographic Factors and Comorbidities Associated with Infective Endocarditis in Patients with Chronic Kidney Disease Undergoing Hemodialysis
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Abstract
Objective: To determine the sociodemographic factors and comorbidities associated with infective endocarditis (EI) in patients with chronic kidney disease undergoing hemodialysis (HD) at Hospital General Regional(HGR) No.1 Charo, Michoacán. Methods: Retrospective cross-sectional study. From January 2019 to December 2022, clinical records, microbiology results, echocardiographic reports, and sociodemographic variables from the social work department were reviewed. All adult records of patients with chronic kidney disease undergoing renal replacement therapy with hemodialysis (HD) and a confirmed diagnosis of infective endocarditis according to the modified Duke criteria (HD-IE Group) were included. Pregnant women and patients who died before confirmation of the diagnosis were excluded. The sample size was calculated using the equation for a proportion, with a 95% confidence level, an estimated precision of 10%, and a 9% proportion of IE cases in HD patients. Results: Ninety patients were included,
45 met the modified Duke criteria for definite infective endocarditis, and 45 were on hemodialysis without infective endocarditis. The mean age at IE presentation was 41.8 years (range: 23–79) with a low socioeconomic status. Arterial hypertension was the most frequent comorbidity; hematologic disease (anemia) was associated with a 19.8-fold increased risk of developing infective endocarditis. The isolated microorganisms were Enterobacteriaceae (26.6%), Staphylococcus aureus (22.2%), and coagulase-negative Staphylococci (22%). Conclusion: The age at presentation of infective endocarditis was lower than internationally reported. The comorbidity associated with infective endocarditis was hematologic disease, and Enterobacteriaceae were more frequent in patients with infective endocarditis on hemodialysis.
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