Relação entre acesso vascular, disfunção renal e alterações bioquímicas na ocorrência de infecções em pacientes com doença renal crônica em hemodiálise

Abstract

This study aimed to analyze the relationship between the type of vascular access, renal function, and biochemical alterations in the occurrence of infections among patients with Chronic Kidney Disease (CKD) undergoing hemodialysis at the Instituto de Nefrologia do Araguaia (INA) in Barra do Garças, Mato Grosso, throughout the year 2023. The sample consisted of 48 patients, divided into two groups, with and without infection related to vascular access, matched by age and sex to minimize bias. The results showed that 73.3% of infected patients were using a central venous catheter (CVC), whereas 39.4% were using an arteriovenous fistula (AVF), indicating a significant association between CVC use and a higher risk of infection (p=0.022). Furthermore, creatinine levels were significantly higher among infected patients (8.48 ± 2.33 mg/dL) compared to the non-infected group (6.64 ± 2.35 mg/dL), with p=0.01, reinforcing the impact of infection on renal dysfunction. Spearman's correlation analysis revealed important biochemical interactions. A strong correlation was observed between total cholesterol and LDL (ρ = 0.896; p<0.001), as well as a moderate correlation between urea and creatinine (ρ = 0.562; p<0.001), reflecting a biochemical pattern consistent with the inflammatory and atherogenic profile commonly described in dialysis patients. Associations were also identified between HDL and clinical variables such as age (negative correlation) and sex, with males exhibiting lower HDL levels. In light of these findings, the need for clinical strategies focused on prioritizing AVF as the preferred vascular access, along with continuous laboratory monitoring—especially in CVC users—is reinforced. Wellstructured care protocols and ongoing training of multidisciplinary teams are essential for preventing infections, minimizing additional renal complications, and optimizing clinical outcomes in this patient population. The study also highlights the relevance of biochemical assessments in monitoring inflammatory status and cardiovascular risk in hemodialysis patients, pointing to pathways for more effective and individualized interventions.