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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Authors: Bakkaloglu, SA, Leventoglu, E, Ezgü, D, Bayrakçi, US, Buder, K, Canpolat, N, Cappoli, A, Cruz, A, Dorresteijn, E, Dönmez, O, Erdogan, H, Göknar, N, Guzzo, I, Bayazit, AK, Lalayiannis, AD, Longo, G, López-Báez, V, Madrid, A, Mehmood, K, Nalçacioglu, H, Obrycki, L, Parmaksiz, G, Peyronel, F, Printza, N, Roussinov, D, Rus, R, Sallam, DE, Stabouli, S, Szczepanska, M, Tabel, Y, Tasdemir, M, Teixeira, A, Tellier, S, Yildiz, N, Zaloszyc, A, Schmitt, CP, Shroff, R, Edefonti, A
Format: article
Status:Published version
Publication Date:2026
Country:España
Institution:Fundació Sant Joan de Déu
Repository:r-FSJD. Repositorio Institucional de Producción Científica de la Fundació Sant Joan de Déu
OAI Identifier:oai:dnet:r-fsjd______::2b425e1e8fe491b02f6fa0ca478731e0
Online Access:https://fsjd.fundanetsuite.com/Publicaciones/ProdCientif/PublicacionFrw.aspx?id=30263
Access Level:Open access
Keyword:Central venous catheter
Catheter-related bloodstream infection
Lock solutions
Pediatric hemodialysis
Vascular access
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spelling Vascular access for hemodialysis and catheter-related bloodstream infections: a survey on preventive measures and treatment strategies by the EPDWG and ESPN Dialysis Working GroupBakkaloglu, SALeventoglu, EEzgü, DBayrakçi, USBuder, KCanpolat, NCappoli, ACruz, ADorresteijn, EDönmez, OErdogan, HGöknar, NGuzzo, IBayazit, AKLalayiannis, ADLongo, GLópez-Báez, VMadrid, AMehmood, KNalçacioglu, HObrycki, LParmaksiz, GPeyronel, FPrintza, NRoussinov, DRus, RSallam, DEStabouli, SSzczepanska, MTabel, YTasdemir, MTeixeira, ATellier, SYildiz, NZaloszyc, ASchmitt, CPShroff, REdefonti, ACentral venous catheterCatheter-related bloodstream infectionLock solutionsPediatric hemodialysisVascular accessThe 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. Conclusion: The suboptimal adherence to current VA recommendations and wide variability in catheter care practices including the prevention, diagnosis, and management of CRBSI highlight the need for standardized pediatric-specific protocols to enhance catheter longevity and improve patient outcomes. What is Known: center dot Central venous catheters are widely used in pediatric hemodialysis but carry a high risk of complications, especially catheter-related bloodstream infections (CRBSI). What is New: center dot This multinational survey reveals significant variability in vascular access selection, CRBSI prevention, diagnosis, and treatment across European pediatric hemodialysis centers, with clear disparities by national HDI levels. center dot The findings highlight the need for standardization of vascular access care and CRBSI management and evidence-based pediatric-specific guidelines.SPRINGER2026info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionhttps://fsjd.fundanetsuite.com/Publicaciones/ProdCientif/PublicacionFrw.aspx?id=30263EUROPEAN JOURNAL OF PEDIATRICSISSN: 03406199ISSNe: 14321076reponame:r-FSJD. Repositorio Institucional de Producción Científica de la Fundació Sant Joan de Déuinstname:Fundació Sant Joan de DéuInglésinfo:eu-repo/semantics/openAccessoai:dnet:r-fsjd______::2b425e1e8fe491b02f6fa0ca478731e02026-05-27T12:37:41Z
dc.title.none.fl_str_mv 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
title 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
spellingShingle 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
Bakkaloglu, SA
Central venous catheter
Catheter-related bloodstream infection
Lock solutions
Pediatric hemodialysis
Vascular access
title_short 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
title_full 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
title_fullStr 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
title_full_unstemmed 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
title_sort 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
dc.creator.none.fl_str_mv Bakkaloglu, SA
Leventoglu, E
Ezgü, D
Bayrakçi, US
Buder, K
Canpolat, N
Cappoli, A
Cruz, A
Dorresteijn, E
Dönmez, O
Erdogan, H
Göknar, N
Guzzo, I
Bayazit, AK
Lalayiannis, AD
Longo, G
López-Báez, V
Madrid, A
Mehmood, K
Nalçacioglu, H
Obrycki, L
Parmaksiz, G
Peyronel, F
Printza, N
Roussinov, D
Rus, R
Sallam, DE
Stabouli, S
Szczepanska, M
Tabel, Y
Tasdemir, M
Teixeira, A
Tellier, S
Yildiz, N
Zaloszyc, A
Schmitt, CP
Shroff, R
Edefonti, A
author Bakkaloglu, SA
author_facet Bakkaloglu, SA
Leventoglu, E
Ezgü, D
Bayrakçi, US
Buder, K
Canpolat, N
Cappoli, A
Cruz, A
Dorresteijn, E
Dönmez, O
Erdogan, H
Göknar, N
Guzzo, I
Bayazit, AK
Lalayiannis, AD
Longo, G
López-Báez, V
Madrid, A
Mehmood, K
Nalçacioglu, H
Obrycki, L
Parmaksiz, G
Peyronel, F
Printza, N
Roussinov, D
Rus, R
Sallam, DE
Stabouli, S
Szczepanska, M
Tabel, Y
Tasdemir, M
Teixeira, A
Tellier, S
Yildiz, N
Zaloszyc, A
Schmitt, CP
Shroff, R
Edefonti, A
author_role author
author2 Leventoglu, E
Ezgü, D
Bayrakçi, US
Buder, K
Canpolat, N
Cappoli, A
Cruz, A
Dorresteijn, E
Dönmez, O
Erdogan, H
Göknar, N
Guzzo, I
Bayazit, AK
Lalayiannis, AD
Longo, G
López-Báez, V
Madrid, A
Mehmood, K
Nalçacioglu, H
Obrycki, L
Parmaksiz, G
Peyronel, F
Printza, N
Roussinov, D
Rus, R
Sallam, DE
Stabouli, S
Szczepanska, M
Tabel, Y
Tasdemir, M
Teixeira, A
Tellier, S
Yildiz, N
Zaloszyc, A
Schmitt, CP
Shroff, R
Edefonti, A
author2_role author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
dc.subject.none.fl_str_mv Central venous catheter
Catheter-related bloodstream infection
Lock solutions
Pediatric hemodialysis
Vascular access
topic Central venous catheter
Catheter-related bloodstream infection
Lock solutions
Pediatric hemodialysis
Vascular access
description 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. Conclusion: The suboptimal adherence to current VA recommendations and wide variability in catheter care practices including the prevention, diagnosis, and management of CRBSI highlight the need for standardized pediatric-specific protocols to enhance catheter longevity and improve patient outcomes. What is Known: center dot Central venous catheters are widely used in pediatric hemodialysis but carry a high risk of complications, especially catheter-related bloodstream infections (CRBSI). What is New: center dot This multinational survey reveals significant variability in vascular access selection, CRBSI prevention, diagnosis, and treatment across European pediatric hemodialysis centers, with clear disparities by national HDI levels. center dot The findings highlight the need for standardization of vascular access care and CRBSI management and evidence-based pediatric-specific guidelines.
publishDate 2026
dc.date.none.fl_str_mv 2026
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv https://fsjd.fundanetsuite.com/Publicaciones/ProdCientif/PublicacionFrw.aspx?id=30263
url https://fsjd.fundanetsuite.com/Publicaciones/ProdCientif/PublicacionFrw.aspx?id=30263
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.rights.none.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.publisher.none.fl_str_mv SPRINGER
publisher.none.fl_str_mv SPRINGER
dc.source.none.fl_str_mv EUROPEAN JOURNAL OF PEDIATRICS
ISSN: 03406199
ISSNe: 14321076
reponame:r-FSJD. Repositorio Institucional de Producción Científica de la Fundació Sant Joan de Déu
instname:Fundació Sant Joan de Déu
instname_str Fundació Sant Joan de Déu
reponame_str r-FSJD. Repositorio Institucional de Producción Científica de la Fundació Sant Joan de Déu
collection r-FSJD. Repositorio Institucional de Producción Científica de la Fundació Sant Joan de Déu
repository.name.fl_str_mv
repository.mail.fl_str_mv
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