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Vascular access for hemodialysis and catheter-related bloodstream infections: a survey on preventive measures and treatment strategies by the EPDWG and ESPN Dialysis Working Group

The choice of vascular access (VA) plays a key role in the success of hemodialysis (HD). Despite their widespread use, central venous catheters (CVCs) are associated with higher rates of dysfunction, thrombosis, and catheter-related bloodstream infections (CRBSI). We investigated current practices i...

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Main Authors: Bakkaloğlu, Sevcan A. (Author) , Leventoğlu, Emre (Author) , Ezgü, Defne (Author) , Bayrakçı, Umut Selda (Author) , Buder, Kathrin (Author) , Canpolat, Nur (Author) , Cappoli, Andrea (Author) , Cruz, Alejandro (Author) , Dorresteijn, Eiske (Author) , Dönmez, Osman (Author) , Erdoğan, Hakan (Author) , Göknar, Nilüfer (Author) , Guzzo, Isabella (Author) , Bayazıt, Aysun Karabay (Author) , Lalayiannis, Alexander D. (Author) , Longo, Germana (Author) , López-Báez, Victor (Author) , Madrid, Alvaro (Author) , Mehmood, Kashif (Author) , Nalçacıoğlu, Hülya (Author) , Obrycki, Lukasz (Author) , Parmaksız, Gönül (Author) , Peyronel, Francesco (Author) , Printza, Nikoleta (Author) , Roussinov, Dimitar (Author) , Rus, Rina (Author) , Sallam, Dina E. (Author) , Stabouli, Stella (Author) , Szczepanska, Maria (Author) , Tabel, Yılmaz (Author) , Taşdemir, Mehmet (Author) , Teixeira, Ana (Author) , Tellier, Stéphanie (Author) , Yıldız, Nurdan (Author) , Zaloszyc, Ariane (Author) , Schmitt, Claus P. (Author) , Shroff, Rukshana (Author) , Edefonti, Alberto (Author)
Format: Article (Journal)
Language:English
Published: 7 January 2026
In: European journal of pediatrics
Year: 2026, Volume: 185, Pages: 1-11
ISSN:1432-1076
DOI:10.1007/s00431-025-06703-7
Online Access:Verlag, kostenfrei, Volltext: https://doi.org/10.1007/s00431-025-06703-7
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Author Notes:Sevcan A. Bakkaloğlu, Emre Leventoğlu, Defne Ezgü, Umut Selda Bayrakçı, Kathrin Buder, Nur Canpolat, et al.
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Summary:The choice of vascular access (VA) plays a key role in the success of hemodialysis (HD). Despite their widespread use, central venous catheters (CVCs) are associated with higher rates of dysfunction, thrombosis, and catheter-related bloodstream infections (CRBSI). We investigated current practices in pediatric HD across European pediatric nephrology centers, focusing on VA choices, infection control measures, and CRBSI management. An online questionnaire was e-mailed to 119 members of the European Society for Pediatric Nephrology (ESPN) Dialysis Working Group and European Pediatric Dialysis Working Group (EPDWG). Descriptive statistics were used to summarize practices across centers, comparative analyses between centers in countries with Human Development Index (HDI) > 0.90 and < 0.90. Thirty-one centers across Europe participated in the survey. CVCs were the primary VA in 73.1% of the centers. Twenty (66.7%) centers reported malfunction as the most common CVC complication, followed by catheter thrombosis (19.4%) and CRBSI (12.9%). The diagnostic approach for CRBSI varied widely, with 35.4% of centers relying on a single positive catheter culture, while 57.9% did not collect a second culture from the peripheral vein or HD circuit. The most common empirical treatment was glycopeptides combined with third-generation cephalosporins. Nearly all centers used intravenous antibiotics for less than 3 weeks, and over half modified lock solutions with antibiotics following CRBSI diagnosis. Catheter removal practices were inconsistent, even in cases of severe infection. Centers reported a total of 548 HD patients. Exit-site infections and CRBSI were observed in 98 (17.8%) and 155 (28.2%) patients, respectively. CRBSI rates and CRBSI-related catheter replacements were significantly higher in centers from countries with HDI < 0.90 and in centers without a dedicated pediatric HD unit.
Item Description:Online veröffentlicht: 7. Januar 2026
Gesehen am 16.03.2026
Physical Description:Online Resource
ISSN:1432-1076
DOI:10.1007/s00431-025-06703-7

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