American Journal of Kidney Diseases
Volume 50, Issue 6 , Page 1052, December 2007

In Reply

University of Alabama, Birmingham, Alabama

Article Outline

 

We appreciate the authors’ interest in our study.1 Although dialysis catheter–related bacteremia can frequently be treated by either an antibiotic lock or by catheter exchange over a guidewire,2 the former approach has the potential advantage of salvaging the catheter and avoiding additional radiologic procedures. Certainly, the retrospective design of our study is a limitation, and we agree that a randomized clinical trial comparing the 2 treatment strategies is needed to provide a definitive comparison of outcomes. Peripheral blood cultures are preferred to cultures obtained from the catheter, but they are frequently not feasible, either due to thrombosis of peripheral veins or because of the need to avoid damaging veins intended for future vascular access.3 Finally, we do not reuse dialyzers at our dialysis units.

Letters to the Editor may be in response to an article that appeared in AJKD no more than 6 months previously, or may concern a topic of interest to current nephrology. The body of the letter should be as concise as possible and in general should not exceed 250 words. Up to 10 references and 1 figure or table may be included. There is no guarantee that letters will be published. Letters are subject to editing and abridgment without notice.

Letters should be submitted via AJKD’s online manuscript handling site, www.editorialmanager.com/ajkd. More information, including details about how to contact the editorial staff for assistance, is available in the journal’s Information for Authors.

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Acknowledgements 

Support: None.

Financial Disclosure: None.

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References 

  1. Maya ID, Carlton D, Estrada E, Allon M. Treatment of dialysis catheter–related Staphylococcus aureus bacteremia with an antibiotic lock: A quality improvement report. Am J Kidney Dis. 2007;50:289–295
  2. National Kidney Foundation. KDOQI Clinical Practice Guidelines and Clinical Practice Recommendations for Vascular Access, Update 2006. Am J Kidney Dis. 2006;48(suppl 1):S248
  3. Poole CV, Carlton D, Bimbo L, Allon M. Treatment of catheter-related bacteraemia with an antibiotic lock protocol: effect of bacterial pathogen. Nephrol Dial Transplant. 2004;19:1237–1244

PII: S0272-6386(07)01361-3

doi:10.1053/j.ajkd.2007.10.007

Refers to article:

  • Managing Dialysis Catheter–Related Staphylococcus aureus Bacteremia

    Tushar Jitendra Vachharajani, Shahriar Moossavi
    American Journal of Kidney Diseases December 2007 (Vol. 50, Issue 6, Page 1052)

American Journal of Kidney Diseases
Volume 50, Issue 6 , Page 1052, December 2007

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