Infectious complications of the hemodialysis access George M. Nassar, Juan Carlos Ayus, M.D.  Kidney International  Volume 60, Issue 1, Pages 1-13 (July 2001) DOI: 10.1046/j.1523-1755.2001.00765.x Copyright © 2001 International Society of Nephrology Terms and Conditions

Figure 1 Management of infection in hemodialysis (HD) patients whose vascular access is a tunneled central venous dialysis catheter. Kidney International 2001 60, 1-13DOI: (10.1046/j.1523-1755.2001.00765.x) Copyright © 2001 International Society of Nephrology Terms and Conditions

Figure 2 Management of infection in hemodialysis (HD) patients whose vascular access is a synthetic arteriovenous (AV) graft. Kidney International 2001 60, 1-13DOI: (10.1046/j.1523-1755.2001.00765.x) Copyright © 2001 International Society of Nephrology Terms and Conditions

Figure 3 Indium 111-labeled leukocyte scan showing diffuse and intense tracer uptake in a prosthetic upper arm arteriovenous graft indicating high likelihood of infection. The scan also shows mild tracer uptake in a prosthetic forearm arteriovenous graft also suspicious for infection. These grafts were old, clotted, and nonfunctional accesses in a 63-year-old woman on HD suffering from hypoalbuminemia and anemia resistant to erythropoietin. Surgical excision of these grafts uncovered purulent material, from which S. aureus organisms were recovered. Following graft excision and treatment with antimicrobials, serum albumin increased and erythropoietin resistance resolved. Note that tracer uptake by bone, as seen on the scan, is not of pathologic significance. Kidney International 2001 60, 1-13DOI: (10.1046/j.1523-1755.2001.00765.x) Copyright © 2001 International Society of Nephrology Terms and Conditions

Figure 4 Initial management and empiric use of antimicrobials in hemodialysis (HD) patients with fever. MRSA denotes methicillin-resistant S. aureus. Kidney International 2001 60, 1-13DOI: (10.1046/j.1523-1755.2001.00765.x) Copyright © 2001 International Society of Nephrology Terms and Conditions