Abstract: FR-PO0530
Hemodiafiltration and Peritoneal Dialysis (PD) Associated with Lower Infection Complications Related to Dialysis Access in Patients with Stage 5 CKD: Partial Results from a Brazilian Multicenter Real-World Study
Session Information
- Home Dialysis: Clinical Epidemiology
November 07, 2025 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Dialysis
- 802 Dialysis: Home Dialysis and Peritoneal Dialysis
Authors
- Dantas, Cássia Lopes, Universidade Estadual Paulista Julio de Mesquita Filho, São Paulo, SP, Brazil
- Vieira, Tales Dantas, Universidade Estadual Paulista Julio de Mesquita Filho, São Paulo, SP, Brazil
- Alves, Camila Albuquerque, Universidade Estadual Paulista Julio de Mesquita Filho, São Paulo, SP, Brazil
- Kojima, Christiane, Universidade Estadual Paulista Julio de Mesquita Filho, São Paulo, SP, Brazil
- Barbosa, Bianca Vitória dos Santos, Universidade Estadual Paulista Julio de Mesquita Filho, São Paulo, SP, Brazil
- Rocha, Érica Pires da, Universidade Estadual Paulista Julio de Mesquita Filho, São Paulo, SP, Brazil
- Silva, Maryanne Zilli Canedo, Universidade Estadual Paulista Julio de Mesquita Filho, São Paulo, SP, Brazil
- Mazzali, Marilda, Universidade Estadual de Campinas, Campinas, SP, Brazil
- Modelli de Andrade, Luis Gustavo, Universidade Estadual Paulista Julio de Mesquita Filho, São Paulo, SP, Brazil
- Ponce, Daniela, Universidade Estadual Paulista Julio de Mesquita Filho, São Paulo, SP, Brazil
Background
The choice of dialysis method can impact infection complications related to dialysis access in patients with end stage renal disease (ESRD). Hemodiafiltration (HDF) has been associated with improved control of uremic toxins, influencing the reduction of these infectious events. However, research evaluating infection complications across different modalities is still scarce in Latin America and lacks validation in real, heterogeneous populations.Objective To assess the prevalence of infection complications related to dialysis access in patients undergoing HDF, HD, and PD.
Methods
A multicenter, retrospective cohort study was conducted with patients with CKD stage 5 who started renal replacement therapy (RRT) between January 2019 and September 2024. Patients were followed for at least 24 months or until an outcome occurred (peritonitis, bloodstream infection, or exit site infection). Data were extracted from electronic records.Continuous variables were described as medians with interquartile ranges, and access infections were analyzed using quasi-Poisson regression models, adjusting for relevant sociodemographic and clinical factors.
Results
A total of 282 patients were included: 129 in HD, 70 in PD, and 83 in HDF. The median age was 61 years, with a male predominance (61%). Most patients were white (68%) and had education up to elementary school (46%). The prevalence of diabetes was 52%, and cardiovascular diseases, 28%. The median number of infections was 2.0 in the HD group, and 0.0 in both the PD and HDF groups (p < 0.001). Multivariate analysis revealed that PD (HR = 0.23; 95% CI: 0.12–0.40; p < 0.001) and HDF (HR = 0.16; 95% CI: 0.08–0.29; p < 0.001) were associated with lower infection rates compared to HD. Although lower education levels correlated with higher infection rates in univariate analysis, this was not significant in the adjusted model.
Conclusion
In this multicenter study, DP and HDF were associated with a lower risk of infection compared to HD, highlighting the need for HDF to be included in the public health system and for greater incentives to promote the use of DP.