A dialysis patient in Sacramento, Calif. New CDC data highlights racial disparities in the risk of bloodstream infections among dialysis patients.
Rich Pedroncelli/AP
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Rich Pedroncelli/AP
A dialysis patient in Sacramento, Calif. New CDC data highlights racial disparities in the risk of bloodstream infections among dialysis patients.
Rich Pedroncelli/AP
Data show that black and Hispanic dialysis patients in the US have a higher risk of developing bloodstream infections than their white counterparts, federal health officials say, adding that reducing the disparities could save lives.
Monday’s report from the Centers for Disease Control and Prevention sheds light on the risks and complications associated with dialysis for end-stage kidney disease, in which a machine does the work of those organs by removing waste and excess fluid from the blood.
“More than half of the people receiving dialysis in the US belong to a racial or ethnic minority group — about 1 in every 3 people receiving dialysis is black and 1 in every 5 is Hispanic,” the CDC said in a release. “CDC data found dialysis patients in these groups have higher rates of bloodstream staph infections than white dialysis patients.”
Dialysis treatment is necessary for individuals whose kidneys are failing — often from high blood pressure, diabetes, lupus or other conditions — but it comes with risks, the CDC says.
Patients are connected to machines with needles or catheters; Staphylococcus and other bacteria can enter their blood. Dialysis facilities reported more than 14,000 bloodstream infections to the national research system in 2020, 34% of which were due to staph. Some 560,000 Americans with end-stage kidney disease received dialysis that year.
Some staph infections are resistant to the antibiotics that commonly treat them, and can be fatal.
Between 2017 and 2020, the CDC found that adults on dialysis for end-stage kidney disease were 100 times more likely to have a bloodstream infection than adults who did not receive the treatment. Hispanics had a 40% higher risk of those infections than white patients at that time.
After adjusting for age, sex and other factors, the study concluded that Hispanic patients and those between 18-49 years of age are at the highest risk, as are people living in areas with higher poverty, household density and lower education.
The CDC outlined other common challenges many dialysis patients face, including lack of access to preventive care for conditions such as diabetes and high blood pressure and a lack of patient education about proper treatment for end-stage kidney disease.
The risk rate of bloodstream infections among black patients was 23% higher than white patients, but when the CDC adjusted for other factors it was not statistically significant, reports CNBC.
“It is still important to emphasize these elevated rates because bloodstream staph infections occur at a higher rate in black patients on dialysis but there are other factors that contribute to the elevated rate outside of race alone,” CDC spokeswoman Martha Sharan told the outlet.
There is some encouraging news, however: Blood stream infections in dialysis patients have decreased since 2014, and there are steps patients and healthcare providers can take to avoid them.
“Dialysis-associated bloodstream infections are preventable – not inevitable,” said Dr. Shannon Novosad, dialysis safety team lead at the CDC Division of Healthcare Quality Promotion.
That’s what public health and healthcare professionals can do
The CDC says the best way to prevent blood staph infections is to detect chronic kidney disease early enough for patients to need dialysis altogether.
“Healthcare providers can prevent preventive practices, including methods to manage diabetes and high blood pressure, as well as education about well-being among all patients and especially those at the highest risk of developing chronic kidney disease,” says the CDC’s Chief Medical Officer. Debra Hory official.
The report emphasizes the importance of reducing barriers to care by providing transportation assistance, professional insurance coverage, social services and educational resources in multiple languages.
While chronic kidney disease is usually irreversible, certain nutritional, lifestyle and medical interventions can help slow its progression. They contain sodium limitation, quitting smoking and improving blood pressure control.
When dialysis is necessary, the CDC says providers should prioritize methods that lower the risk of infection, including using proven infection prevention and control practices. It could also mean using tubes or inserts instead of higher-risk catheters.
“Education and implementation of established best practices to prevent bloodstream infections are critical to overall protection.” [dialysis] of the patient community, the study concludes, “they are most at risk.”
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