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Abstract: FR-PO765

High Risk of Pyogenic Spondylitis in CKD Patients: Its Characteristics and Incidence

Session Information

Category: Dialysis

  • 701 Dialysis: Hemodialysis and Frequent Dialysis

Authors

  • Oki, Rikako, Shonan Kamakura General Hospital, Kamakura, Kanagawa, Japan
  • Moriya, Hidekazu, Shonan Kamakura General Hospital, Kamakura, Kanagawa, Japan
  • Mochida, Yasuhiro, Shonan Kamakura General Hospital, Kamakura, Kanagawa, Japan
  • Ishioka, Kunihiro, Shonan Kamakura General Hospital, Kamakura, Kanagawa, Japan
  • Hidaka, Sumi, Shonan Kamakura General Hospital, Kamakura, Kanagawa, Japan
  • Ohtake, Takayasu, Shonan Kamakura General Hospital, Kamakura, Kanagawa, Japan
  • Kobayashi, Shuzo, Shonan Kamakura General Hospital, Kamakura, Kanagawa, Japan
Background

Pyogenic spondylitis is a rare but life- threatening disease. Mortality has been reported to be approximately up to 11% with the incidence of 2.5 - 7.4/100,000 population per year, particularly more in elderly people or compromised hosts. CKD patients often have infectious complications. However, little information is available regarding the incidence of this disorder in CKD patients. In this study, we examined to clarify the incidence and characteristics of pyogenic spondylitis in CKD patients.

Methods

A retrospective observational study was conducted in our hospital. Fifty-seven patients (45 CKD patients without HD (eGFR < 60ml/min/1.73m2) [ND] and 12 HD patients [HD]) were diagnosed to have pyogenic spondylitis between January 2012 and October 2016. We investigated age, disease background, affected site, causative microorganism, therapy, hospitalization period, mortality rate, causes of death in ND group and HD group.

Results

Median of age in all patients was 79 years old (IQR: 72-86): 54% were male, 30% had diabetes and 21% were HD patients. In-hospital mortality was 23%, and average hospitalization period was 55 days. Staphylococci species were the most frequent pathogen (49%). Comorbidities are diabetes (30%), ischemic heart disease (17.5%), peripheral vascular disease (11%), and cerebral vascular disease (10%). There was no significant difference in hospitalization period and mortality rate between ND and HD group. The rate of pyogenic spondylitis caused by Staphylococci tended to be higher in HD group(P=0.056). Fifty percent of pyogenic spondylitis developed due to infection of AV fistula (AVF), and the causative microorganism of all cases due to infection of AVF was Staphylococci.

Conclusion

Mortality of pyogenic spondylitis is high in CKD patients. Bacteremia caused by blood access infection is a risk factor of pyogenic spondylitis and more attention should be paid to infection of AVF.