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Infections in Pediatric Patients with End-Stage Renal Disease

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Healthcare-Associated Infections in Children

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Abstract

End-stage renal disease (ESRD) is a state of acquired immune deficiency. Children with ESRD have a shortened life expectancy without transplantation. Deaths due to infection are only second in frequency to cardiovascular causes in both children and adults with ESRD. Although loss of skin barrier due to the presence of indwelling catheters seems to be the most obvious explanation, other factors such as malnutrition, dysregulated inflammation, and acquired immune dysfunction due to uremia contribute to the immune deficiency of ESRD. Infectious complications also constitute a large morbidity, leading to frequent hospitalization and increased resource utilization in the ESRD population. This chapter reviews factors predisposing to infections in children with ESRD and examines the burden of infectious complications in two common dialysis modalities, hemodialysis and peritoneal dialysis. Definitions of dialysis-related infections are presented as well as their epidemiology, microbiology, and management including indications for catheter removal versus medical treatment with catheter in situ. Renal transplantation, conventionally considered hand in hand with ESRD, is outside the scope of this chapter and will not be discussed.

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Authors and Affiliations

  1. Department of Pediatrics, Sections of Critical Care Medicine and Renal, Baylor College of Medicine, Houston, TX, USA

    Ayse Akcan-Arikan

  2. Department of Pediatrics, Section of Renal, Baylor College of Medicine, Houston, TX, USA

    Sarah J. Swartz & Poyyapakkam R. Srivaths

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  1. Ayse Akcan-Arikan
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  2. Sarah J. Swartz
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  3. Poyyapakkam R. Srivaths
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Correspondence to Ayse Akcan-Arikan .

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Editors and Affiliations

  1. Department of Pediatrics, Section of Infectious Diseases, Baylor College of Medicine and Texas Children’s Hospital, Houston, TX, USA

    J. Chase McNeil

  2. Department of Pediatrics, Section of Infectious Diseases, Baylor College of Medicine and Texas Children’s Hospital, Houston, TX, USA

    Judith R. Campbell

  3. Department of Pediatrics, Baylor College of Medicine and The Children’s Hospital of San Antonio, San Antonio, TX, USA

    Jonathan D. Crews

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Akcan-Arikan, A., Swartz, S.J., Srivaths, P.R. (2019). Infections in Pediatric Patients with End-Stage Renal Disease. In: McNeil, J., Campbell, J., Crews, J. (eds) Healthcare-Associated Infections in Children. Springer, Cham. https://doi.org/10.1007/978-3-319-98122-2_18

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