The Japanese Journal of Clinical Dialysis Vol.17 No.8(2-6)

Theme Infections Diseases in Hemodialysis Patients -- the Progress of Diagnosis and Therapy
Title Infections disease in dialysis patients with urological diseases
Publish Date 2001/07
Author Ken Nakagawa Department of Urology, Keio University School of Medicine
Author Masaru Murai Department of Urology, Keio University School of Medicine
[ Summary ] Since the host defense mechanisms are impaired in dialysis patients, infections become difficult to control and represent the second major cause of death. Additionally, because a reduction in urine volume cannot be avoided in such patients, most of them develop urinary tract infections, which become the main therapeutic problem. If these infections co-exist with a urological disease, complicated urinary tract infection may develop, and this frequently retards treatment and changes a patient's state into a severe illness. Although a high infection rate is observed in cystic renal disease, especially in polycystic kidneys, a total understanding of disorders that cause urine retention, like urinary tract obstruction and functional disorders, is crucial. This concerns not only urologists but also other specialists dealing with dialysis and, to some extent, it should be understood that advanced-age dialysis patients with obstructive uropathy develop urinary tract malignant tumors and/or prostatic hypertrophy, and diabetic patients with functional urinary tract obstruction suffer from neurogenic bladder and/or similar pathologies. If a patient on dialysis develops a complicated urinary tract infection, the patient may require prompt therapeutic response not only to the infection, but also to the primary disease.
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