Extra-renal abscess in chronic hemodialysis patients

Feng Rong Chuang, Chih Hsiung Lee, Jin Bor Chen, Yuan Fu Cheng, Bor Yau Yang, Kuo Tai Hsu, Mai Szu Wu

Research output: Contribution to journalArticle

11 Citations (Scopus)

Abstract

Aim: Infectious disease represents one of the major causes of morbidity and mortality in hemodialysis patients. Extra-renal abscess constitutes a specific form of infection. The aim of this study was to evaluate and analyze the clinical characteristics of extra-renal abscess in chronic hemodialysis patients. Methods: We retrospectively studied the extra-renal abscess among chronic hemodialysis patients in Chang Gung Memorial Hospital at Kaohsiung, Taiwan. The records of 2168 chronic hemodialysis patients from October 1986 to January 2000, were studied. The clinical features were reviewed and analyzed. Results: Sixteen patients who were enrolled during the study period developed extra-renal abscess. Ten of them were male. The mean age was 59.2 ± 11.8 years old. More than half of the patients had diabetes (53.6%, 9/16). The locations of extra-renal abscess in these patients were liver (8/16), lung (5/16), spleen (1/16), perianal region (1/16), psoas muscle (1/16), and prostate (1/16). One patient had concurrent liver and spleen abscesses. All patients presented with fever and chills. Laboratory studies revealed leukocytosis and thrombocytopenia in 2/3 of the patients. The patients were associated with malnutrition status with lower serum albumin level (2.94 ± 0.55 gm/dL) and lower nPCR (normalized protein catabolism rate; 0.84 ± 0.11 gm/Kg/day) comparing to the other hemodialysis patients (albumin: 4.05 ± 0.47 gm/dL; nPCR: 1.14 ± 0.31 gm/kg/day). There was no significant difference in kt/V between the patients with (1.28 ± 0.34) or without abscess formation (1.47 ± 0.36). The major causative pathogen was Klebsiella pneumoniae. Parenteral antibiotic treatment is sufficient to treat most of the diseases, except 2 patients who needed surgical intervention. Twelve patients recovered after 2-3 weeks of treatment. Conclusions: The study indicated that extra-renal abscess is rare in chronic hemodialysis patients. The abscesses occurred mostly in liver. Diabetes mellitus and poor nutrition status were the important predisposing factors. Gram-negative bacilli, K. pneumoniae, were the major pathogen. Most of the patients responded to parenteral antibiotics and surgical draining.

Original languageEnglish
Pages (from-to)511-521
Number of pages11
JournalRenal Failure
Volume24
Issue number4
DOIs
Publication statusPublished - 2002
Externally publishedYes

Fingerprint

Abscess
Renal Dialysis
Kidney
Klebsiella pneumoniae
Spleen
Psoas Muscles
Anti-Bacterial Agents
Chills
Liver Abscess
Liver
Leukocytosis
Nutritional Status
Taiwan
Serum Albumin
Malnutrition
Causality
Bacillus
Communicable Diseases
Prostate
Albumins

Keywords

  • Extra-renal abscess
  • Hemodialysis

ASJC Scopus subject areas

  • Nephrology

Cite this

Chuang, F. R., Lee, C. H., Chen, J. B., Cheng, Y. F., Yang, B. Y., Hsu, K. T., & Wu, M. S. (2002). Extra-renal abscess in chronic hemodialysis patients. Renal Failure, 24(4), 511-521. https://doi.org/10.1081/JDI-120006778

Extra-renal abscess in chronic hemodialysis patients. / Chuang, Feng Rong; Lee, Chih Hsiung; Chen, Jin Bor; Cheng, Yuan Fu; Yang, Bor Yau; Hsu, Kuo Tai; Wu, Mai Szu.

In: Renal Failure, Vol. 24, No. 4, 2002, p. 511-521.

Research output: Contribution to journalArticle

Chuang, FR, Lee, CH, Chen, JB, Cheng, YF, Yang, BY, Hsu, KT & Wu, MS 2002, 'Extra-renal abscess in chronic hemodialysis patients', Renal Failure, vol. 24, no. 4, pp. 511-521. https://doi.org/10.1081/JDI-120006778
Chuang FR, Lee CH, Chen JB, Cheng YF, Yang BY, Hsu KT et al. Extra-renal abscess in chronic hemodialysis patients. Renal Failure. 2002;24(4):511-521. https://doi.org/10.1081/JDI-120006778
Chuang, Feng Rong ; Lee, Chih Hsiung ; Chen, Jin Bor ; Cheng, Yuan Fu ; Yang, Bor Yau ; Hsu, Kuo Tai ; Wu, Mai Szu. / Extra-renal abscess in chronic hemodialysis patients. In: Renal Failure. 2002 ; Vol. 24, No. 4. pp. 511-521.
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AU - Hsu, Kuo Tai

AU - Wu, Mai Szu

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N2 - Aim: Infectious disease represents one of the major causes of morbidity and mortality in hemodialysis patients. Extra-renal abscess constitutes a specific form of infection. The aim of this study was to evaluate and analyze the clinical characteristics of extra-renal abscess in chronic hemodialysis patients. Methods: We retrospectively studied the extra-renal abscess among chronic hemodialysis patients in Chang Gung Memorial Hospital at Kaohsiung, Taiwan. The records of 2168 chronic hemodialysis patients from October 1986 to January 2000, were studied. The clinical features were reviewed and analyzed. Results: Sixteen patients who were enrolled during the study period developed extra-renal abscess. Ten of them were male. The mean age was 59.2 ± 11.8 years old. More than half of the patients had diabetes (53.6%, 9/16). The locations of extra-renal abscess in these patients were liver (8/16), lung (5/16), spleen (1/16), perianal region (1/16), psoas muscle (1/16), and prostate (1/16). One patient had concurrent liver and spleen abscesses. All patients presented with fever and chills. Laboratory studies revealed leukocytosis and thrombocytopenia in 2/3 of the patients. The patients were associated with malnutrition status with lower serum albumin level (2.94 ± 0.55 gm/dL) and lower nPCR (normalized protein catabolism rate; 0.84 ± 0.11 gm/Kg/day) comparing to the other hemodialysis patients (albumin: 4.05 ± 0.47 gm/dL; nPCR: 1.14 ± 0.31 gm/kg/day). There was no significant difference in kt/V between the patients with (1.28 ± 0.34) or without abscess formation (1.47 ± 0.36). The major causative pathogen was Klebsiella pneumoniae. Parenteral antibiotic treatment is sufficient to treat most of the diseases, except 2 patients who needed surgical intervention. Twelve patients recovered after 2-3 weeks of treatment. Conclusions: The study indicated that extra-renal abscess is rare in chronic hemodialysis patients. The abscesses occurred mostly in liver. Diabetes mellitus and poor nutrition status were the important predisposing factors. Gram-negative bacilli, K. pneumoniae, were the major pathogen. Most of the patients responded to parenteral antibiotics and surgical draining.

AB - Aim: Infectious disease represents one of the major causes of morbidity and mortality in hemodialysis patients. Extra-renal abscess constitutes a specific form of infection. The aim of this study was to evaluate and analyze the clinical characteristics of extra-renal abscess in chronic hemodialysis patients. Methods: We retrospectively studied the extra-renal abscess among chronic hemodialysis patients in Chang Gung Memorial Hospital at Kaohsiung, Taiwan. The records of 2168 chronic hemodialysis patients from October 1986 to January 2000, were studied. The clinical features were reviewed and analyzed. Results: Sixteen patients who were enrolled during the study period developed extra-renal abscess. Ten of them were male. The mean age was 59.2 ± 11.8 years old. More than half of the patients had diabetes (53.6%, 9/16). The locations of extra-renal abscess in these patients were liver (8/16), lung (5/16), spleen (1/16), perianal region (1/16), psoas muscle (1/16), and prostate (1/16). One patient had concurrent liver and spleen abscesses. All patients presented with fever and chills. Laboratory studies revealed leukocytosis and thrombocytopenia in 2/3 of the patients. The patients were associated with malnutrition status with lower serum albumin level (2.94 ± 0.55 gm/dL) and lower nPCR (normalized protein catabolism rate; 0.84 ± 0.11 gm/Kg/day) comparing to the other hemodialysis patients (albumin: 4.05 ± 0.47 gm/dL; nPCR: 1.14 ± 0.31 gm/kg/day). There was no significant difference in kt/V between the patients with (1.28 ± 0.34) or without abscess formation (1.47 ± 0.36). The major causative pathogen was Klebsiella pneumoniae. Parenteral antibiotic treatment is sufficient to treat most of the diseases, except 2 patients who needed surgical intervention. Twelve patients recovered after 2-3 weeks of treatment. Conclusions: The study indicated that extra-renal abscess is rare in chronic hemodialysis patients. The abscesses occurred mostly in liver. Diabetes mellitus and poor nutrition status were the important predisposing factors. Gram-negative bacilli, K. pneumoniae, were the major pathogen. Most of the patients responded to parenteral antibiotics and surgical draining.

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