Infective Endocarditis in Patients Receiving Hemodialysis: A Current Review

Background:Cardiovascular and infective complications arecommonly observed in patients receiving hemodialysis (HD)with cardiovascular events and infection-related complica-tions being thefirst and second leading causes of death.Infective endocarditis (IE) is characterized by inflammationof the endocardium caused by infection, typically affectingthe cardiac valves and can be in acute, subacute, or chronicforms. It is a serious complication within the HD populationdue to their predisposition for both infection and valvulardamage. Considering the frailty and burden of comorbiditiesin those receiving HD, management of IE in the HD pop-ulation is very challenging. There has been continuousdiscussion and debate on optimizing the diagnostic andtreatment approach of IE in this patient group to improvetheir clinical outcomes. Currently, reported outcomes arerelatively poor and there are updates from numerousguidelines relating to advances in IE management.Summary:In this review, we will evaluate the evidence inrelation to the epidemiology of HD-associated IE and discussthe important risk factors of IE in patients requiring dialysis.We will also evaluate the current recommendations re-garding diagnosis and treatment for suspected or confirmedIE cases amongst HD patients and present the updated dataregarding clinical outcomes relating to HD-associated IE.KeyMessages:The incidence of IE in HD patients is expected toincrease going forward as HD becomes more easily acces-sible alongside an emerging uptake of home HD. A morethorough insight into this topic is required to improveclinical practice relating to IE prevention and managementin the HD population, given relatively poor clinicaloutcomes.(c) 2024 The Author(s).Published by S. Karger AG, Basel