State (Colorado) releases dialysis patient infection rate

By JOHN NORTON | norton@chieftain.com |

Over a 12-month period, from April 2010, through March 2011, 664 Colorado dialysis patients suffered some form of infection related to their treatment.

The Colorado Department of Public Health and Environment released those figures this week in a bulletin that’s part of a new reporting process assessing the performance of health care institutions. Previous bulletins since 2008 dealt with cardiac and orthopedic care, intensive care units and others.

The latest report was the first analysis of the dialysis infection problem.

Dialysis replaces the function of the kidney, cleaning the bloodstream of wastes, salts and fluids by tapping a blood vessel, processing the blood and returning it over a period of several hours.

A total of 39,510 Coloradans are on dialysis, 0.8 percent of the state’s population and the number is much higher locally. There are 2,380 Pueblo County residents on dialysis, 1.7 percent of the population.

Many of those people are there because of kidney failure from type 2 diabetes, along with other causes like high blood pressure, infections or other kidney diseases.

A total of 59 dialysis centers reported and the data was separated based on the type of access to patients’ bloodstreams. The most common system uses fistulas, usually inserted into an artery in the arm. The report said 70.3 percent of dialysis patients use them. Also used are grafts, on 12.3 percent and permanent lines on 3.5 percent.

Among Colorado patients, those with fistulas showed the best results, with 176 infections among 26,270 people or a 0.7 percent infection rate. Those with grafts has a 1.2 percent rate. The rates for permanent and temporary central lines were 6.6 and 5.3 percent respectively.

While the U.S. Centers for Disease Control and Prevention rate infections as the second most serious threat to dialysis patients after vascular disease, the state report cautions that infection rates are not the only criteria for selecting care. The bulletin did not break down the numbers by provider, either.

It did recommend, “Consumers should always consult with their doctor, health care facility, health insurance carrier, family and friends before deciding where to receive care. Consumers should consider the experience of the facility, staff and other quality of care indicators.”

Pueblo Chieftain

If someone wants to find out about infection rates etc… at an individual facility, I would highly recommend Propublica’s Dialysis Facility Tracker: http://projects.propublica.org/dialysis/