**7. Differences between case series of IE in ESRD patients**

Since no significant differences are found between the types of valve prosthesis to be placed in HD patients with IE, it is recommended to individualize each case. But as a general rule, bioprosthesis is placed in most HD patients with IE, especially in patients with increased risk of bleeding associated with anticoagulation, leaving mechanical prostheses for young patients without other morbidity in whom life expectancy is longer than the bioprosthesis and also, for

Our group works at a reference center, in the Mexican Institute of Social Security (IMSS for its acronym in Spanish) and takes care of all cardiothoracic surgical patients in the west of Mexico that are affiliated to IMSS. This means that more than 10 states represent more than 8.5 million affiliated people and possible patients. There are other hospitals in western Mexico that deal with endocarditis patients, but a patient who has surgical indication or who is seriously ill is

We retrospectively analyzed the last 5 year cases of IE in our center. There were 173 cases of which 77 (44.5%) were surgically treated. In these 77 patients, 33 (42.85%) patient where in HD. We used the IE in general population guidelines for the decision of medical or surgical

young patients who are candidates for renal transplantation in the future [25].

**6. IE in HD patients in western Mexico**

sent to our center.

treatment in all our patients.

130 Contemporary Challenges in Endocarditis

**Figure 1.** Affected valves in HD patients (IMSS 2011–2015).

The following tables summarizes some of the most representative contemporary case series of IE in ESRD patients published in the last decade. The percentage of HD patients with IE who are undergoing cardiac surgery ranges from 7.8 to 53% in different regions of the world and also the associated pathologies are listed in **Table 1**. *S. aureus* is the microorganism most frequently involved in all series (**Table 1**). The valves involve with IE in previous studies involved most frequently the left side valves (**Table 2**). There are significant differences in the percentage of ESRD patients with AVFs in different regions, the highest being in Europe (**Table 3**). And morbidity and mortality also differ between regions (**Table 4**).



\* For the type of stratification of patients in the publication, the data are present but not reported in this table. NR: not reported.

**Table 1.** Infective endocarditis publications in ESRD patients in dialysis surgical treatment: demographic information.


Infective Endocarditis in End-Stage Renal Disease Patients in Developing Countries: What is the Real Problem? http://dx.doi.org/10.5772/64929 133


**Years in which the study was conducted**

**Participant centers**

**IE patients (n)**

**Cardiac surgery** 

**Male patients** 60.7%

**Hypertension**

**%** 

%

**Immuno suppression**

*Staphylococcus aureus*

reported.

**Authors Doulton T,**

**Journal Kidney**

**Sabharwal N, Cairns H,** *et al.*

**International, 2003; 64: 720-727**

1980–1995, 1995–2002, 1996–2002

132 Contemporary Challenges in Endocarditis

St. Thomas H. Guy´s H. King´s College H. (London)

53% (15/28 pts.)

(17 pts.)

**Mean age** 54.1 (22-81) 55.2

**Diabetic%** 8 33.3%

63.3% MRSA

\* 66.6%

\* 9.5%

1998– 2011

Royal London Hospital. (London)

21% (9/42 pts.)

52.2% (22 pts.)

(43-69)

(14 pts.)

(28 pts.)

(4 pts.)

57.1% (24/42 pts.)

**Jones D, McGill L, Rathod K,** *et al.*

**Nephron Clinical Practice, 2013; 123:151– 156**

Columbus, Ohio Detroit, Michigan Houston, Texas

28 pts. 42 pts. 52 pts. 69 pts. 502 (39

52% 45%

24% (13/52 pts.)

60 (36-82)

42% (22 pts.)

79% (41 pts.)

20% (11 pts.)

**Nori U, Manoharan A, Thornby J,**  *et al.*

**Nephrology Dialysis Transplantation 2006; 21: 2184–2190**

St. John Hospital and Medical Center. Detroit, Michigan.

34% (24/69 pts.)

(31 pts.)

37.7% (26 pts.)

89.9% (62 pts.)

\* For the type of stratification of patients in the publication, the data are present but not reported in this table. NR: not

**Table 1.** Infective endocarditis publications in ESRD patients in dialysis surgical treatment: demographic information.

**Kamalakannan D, Manohara R, Johnson L, et al.**

**Annals of Thoracic Surgery 2007; 83: 2081–2086**

1999–2004 1990–2004 1999–2007 1988–2002 1990–2006

National Taipei

surgical)-7.8

7.8% (39 pts.)

35.9% (14 pts.)

46.2% (18 pts.)

\* (3 pts.) NR \* 5% (3 pts.)

**Chou M, Wang J, Wu W, et al.**

**International Journal of Cardiology 2015; 179:465 –469**

56 +-13 52.6 +- 11.7 64.6+-12.9 57.3 +- 13.8

NR 75%

\* \* \* 45% (27 pts.)

**Chang C, Kuo B, Chen T, et al.**

**Journal of Nephrology 2004; 17: 228– 235**

Veterans General Hospital.

\*(20 /20 pts.)

45% (9 pts.)

(15 pts.)

20 pts. 59 pts.

12% (7/59 pts.)

(13 pts.) 47% (28 pts.)

59% (35)

93% (55)

**Baroudi S, Qazi R, Lentine K, et al.**

**NDT PLUS Nephrology Dialysis Transplantation**

Saint Louis University Hospital.

> \* For the type of stratification of patients in the publication, the data are present but not reported in this table. NR: not reported.

**Table 2.** Infective endocarditis publications in ESRD patients in dialysis surgical treatment: involved heart valves.



\* For the type of stratification of patients in the publication, the data are present but not reported in this table. NR: not reported.

**Table 3.** Infective endocarditis publications in ESRD patients in dialysis surgical treatment: dialysis access route.


\* For the type of stratification of patients in the publication, the data are present but not reported in this table. NR: not reported.

**Table 4.** Infective endocarditis publications in ESRD patients in dialysis surgical treatment: survival, in-hospital mortality, and overall mortality.
