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Infections and Chronic Kidney Disease

What is an infection?

An infection occurs when harmful bacteria or viruses enter the body. These germs can enter the body through touch, through the air we breathe or through our mouths. Your body’s immune system is on constant alert for infection and has a variety of strategies to combat it.

One way is by increasing blood flow to the infected site. This transports white blood cells and antibodies to fight the invading germs. Sometimes this increased blood flow can cause inflammation and it’s one of the first signs of a bacterial infection.

When an infection isn’t specific to one area, but affects your entire body, you may develop a fever. Increasing the body’s internal temperature is one way your immune system weakens the bacteria or virus, allowing your antibodies to fight them. A fever is also one of the first signs your body is fighting bacteria or a virus.

You may feel tired fighting infection. This is a sign that your body wants you to rest. Sometimes an infection can be overwhelming to your body and medical attention is necessary.

Why are people with kidney disease prone to infections?

People with kidney disease can be more prone to infection because of related conditions such as diabetes, inadequate calorie and protein intake, and the access site can be vulnerable to infection.

Diabetes-related infections

If you’ve diabetes and chronic kidney disease (CKD), you may also be at risk for diabetes-related infections. Too much glucose (sugar) in the blood prevents white blood cells from doing their jobs. It’s important to monitor and maintain good glucose levels. Also routinely examine your feet for blisters, sores or ingrown nails. Go to the dentist to make sure you don’t have gum disease or infected teeth.

A viral infection from the flu, or a bacterial infection from a cut or surgical procedure, can cause blood glucose levels to increase, making it longer for people with diabetes to recover.

Access sites

Because access sites allow for the entry and exit of dialysate (for people on peritoneal dialysis, or PD) or blood (for people on hemodialysis), either through a catheter or through puncture with a needle, they can also serve as a possible entry site for bacteria.

Preventing infections

Infections can be small nuisances or become life threatening if allowed to spread throughout the body. Take precautions against infection by following these guidelines:

Keep your access site clean. If you’re on dialysis, you’ll be instructed on how to keep your access site clean and look for any signs of infection. For those who perform home dialysis (PD or home hemodialysis), you’ll be instructed on the importance of hygiene and given instructions on safe home treatment. This includes training your care partner to wash their hands before handling your catheter or access. Germs can spread through touch.
Look for signs of infection. PD patients should look for damage to or cracks on their catheter. Redness, irritation or bleeding are indicators of infection. People on hemodialysis should clean their access site before treatment. Any signs of tenderness or irritation should be reported to your nurse or doctor.
Wash your hands. Cold and flu germs can be on doorknobs, sink faucets and newspapers. If you touch something that someone who’s ill has touched, you risk getting the same infection. Be especially diligent during cold and flu season.
Manage your condition. By following your healthcare team’s recommendations regarding diet, medication and dialysis treatments, you can lower your risk of infection. Missing dialysis means waste and toxins build up in your bloodstream, leaving you weak, ill and prone to infection. If you have any concerns about your diet or medication, talk to your doctor.
Eat nutritious foods. Consuming adequate amounts of protein, calories and nutrients build your body’s immune system. If you are on dialysis, your renal dietitian should create an eating plan based on your individual nutrition needs. Each month you will review your lab report to make sure you’re getting the right amount of nutrients. If you are a DaVita dialysis patient, you can check your lab results on the DaVita^® Health Portal.
Report any signs of infection to your doctor right away. If your access site is severely infected, you may not be able to receive dialysis, so it’s important to alert your doctor immediately. Also, infections to an access site can spread rapidly through the body, complicating your treatment and delaying your recovery time. Consult your doctor if you have a cold or the flu. They’ll want to monitor your condition to make sure it does not worsen.