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Current Infectious Disease Reports

, Volume 5, Issue 4, pp 293–299 | Cite as

Infective endocarditis in patients with kidney failure: Chronic dialysis and kidney transplant

  • James H. E. Ireland
  • James T. McCarthy
Article

Abstract

Physicians who treat patients with infective endocarditis (IE) are encountering a growing number of dialysis and kidney transplant patients. Both groups have 30 to 100 times higher risk of IE, with 1-year mortalities of 40% to 60%. The predominant organisms causing IE are gram positive, with 60% to 80% of cases due to Staphylococcus aureus, and another 10% to 20% of cases due to coagulase-negative staphylococci. Renal transplant patients may develop fungal IE, but this risk is primarily in the first 3 months after transplant. In addition to blood cultures, transesophageal echocardiogram is the most useful diagnostic examination for IE in these patients. Initial antibiotic therapy, pending final culture and antibiotic susceptibility results, should provide coverage against the most common organisms and allow for the potential of either methicillin or vancomycinresistant species. Removal of infected hemodialysis access devices and at least 4 to 6 weeks of intravenous antibiotics are recommended. Antibiotic prophylaxis against IE has been recommended for all dialysis and renal transplant patients, but this strategy is controversial and unproven.

Keywords

Endocarditis Infective Endocarditis Dialysis Patient Hemodialysis Patient Vascular Access 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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Copyright information

© Current Science Inc. 2003

Authors and Affiliations

  • James H. E. Ireland
    • 1
  • James T. McCarthy
    • 1
  1. 1.Mayo Clinic and Mayo FoundationRochesterUSA

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