Kidney Week

Abstract: FR-PO1105

Central Line-Associated Bloodstream Infection in Patients on Assisted Home Hemodialysis vs. In-Center Hemodialysis: A Comparative Cohort Study from Qatar

Session Information

• Home Dialysis: Modalities, Barriers, Utilization, and Clinical Outcomes
  October 23, 2026 | Location: Exhibit Hall A, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Dialysis

• 802 Dialysis: Home Dialysis and Peritoneal Dialysis

Authors

• Filali, Mossab, Hamad Medical Corporation, Doha, Qatar

Mossab Filali, MD

• Hamad, Abdullah Ibrahim, Hamad Medical Corporation, Doha, Qatar

Abdullah Ibrahim Hamad, MD, FASN

• Tolba, Hoda, Hamad Medical Corporation, Doha, Qatar

Hoda Tolba, RN

• Ibrahim, Athar Ibrahim Hassan, Hamad Medical Corporation, Doha, Qatar

Athar Ibrahim Hassan Ibrahim, RN

• Alomari, Anees Jamil, Hamad Medical Corporation, Doha, Qatar

Anees Jamil Alomari, RN

• Chembolu, Sandhya, Hamad Medical Corporation, Doha, Qatar

Sandhya Chembolu, RN

• Frahna, Hala, Hamad Medical Corporation, Doha, Qatar

Hala Frahna, RN

• Ibrahim, Rania Abdelaziz, Hamad Medical Corporation, Doha, Qatar

Rania Abdelaziz Ibrahim, RN

• Elshirbeny, Mostafa, Hamad Medical Corporation, Doha, Qatar

Mostafa Elshirbeny, MD

• Elgaali, Musab, Hamad Medical Corporation, Doha, Qatar

Musab Elgaali, MD

• Al-Malki, Hassan A., Hamad Medical Corporation, Doha, Qatar

Hassan A. Al-Malki, MD

Background

Central Line Associated Bloodstream Infection (CLABSI) is a major complication in maintenance hemodialysis (HD), contributing significantly to hospitalization, morbidity, and healthcare costs. In-center hemodialysis (ICHD) exposes patients to repeated healthcare contact and environmental sources of infection. Assisted home hemodialysis (AHHD), where trained healthcare professionals deliver dialysis in patient's home, combines home-based therapy with structured clinical oversight but remains understudied regarding infection outcomes. We studied CLABSI incidence between AHHD and ICHD.

Methods

We conducted a retrospective cohort study evaluating CLABSI rates among adult patients undergoing AHHD and ICHD between January and December 2025. CLABSI incidence was calculated per 1000 catheter-days. Catheter survival free from CLABSI was analyzed using Kaplan–Meier (KM) methods with log rank testing to compare survival curves between AHHD and ICHD. Cox regression was used to estimate hazard ratios (HR) for time to first CLABSI by dialysis setting. All analyses were performed using SPSS Statistics,V25.

Results

One CLABSI event occurred in AHHD group compared with 22 events in ICHD group, corresponding to incidence rates of 0.03 and 0.30 per 1,000 catheter-days, respectively (p < 0.001). KM analysis demonstrated significantly longer CLABSI-free catheter survival in AHHD compared with ICHD by log-rank testing (p=0.012). In Cox proportional hazards analysis, AHHD was associated with a significantly lower hazard of first CLABSI compared with ICHD (HR 0.12, 95% CI 0.02–0.89; p=0.038).

Conclusion

AHHD was associated with substantially lower CLABSI rates and improved CLABSI-free catheter survival compared with ICHD. The exceptionally low infection rates observed in AHHD cohort may reflect the benefits of home-based HD care, reduced nosocomial exposure, dedicated nursing teams, and highly standardized catheter
management practices.