Infections are one of the leading causes of hospitalizations, dialysis access loss and death for dialysis patients, but fortunately they can be prevented, and when they happen and identified in time, treated with antibiotics.  The key to infection prevention is cleanliness.  Here are some of the things you can do as a patient to decrease the chance of infections.

Knowing when you have an infection is the ?rst step in controlling complications of infection. What are some of the signs and symptoms of infection? Having fever or chills is a symptom of infection. A temperature above 100 degrees should alarm you to contact your doctor. Watch your dialysis access for signs of drainage, redness, swelling, and pain or tenderness. Bring these to the attention of your dialysis staff or physician.  If you are not sure if there is an infection, write down your questions and take them with you to your next dialysis treatment to ask the dialysis staff. 

To reduce chances of infection the single most important thing you can do is to wash with soap to reduce bacteria on your skin around your access. If you have a catheter, keep the dressing clean and dry and always wear a mask when starting and ending your treatment. Remember to wash your hands and the fistula or graft site with soap and warm water in the clinic, just before your treatment.  It may not be enough to take a shower before leaving home, as bacteria is everywhere and may get on your access by the time you reach dialysis.  As a dialysis patient your immune system is not as effective as it was before you developed kidney disease.  This makes your body more prone to invasion of bacteria.  Bacteria can get to your bloodstream from the skin by crawling around the needles inserted for dialysis or around your catheter.  So wash your hands and access site and keep catheter exit site clean to protect yourself.  

Report any sign of infection to your doctor immediately.  Have your doctor phone numbers handy where you or a caregiver can ?nd them easily.  A bad infection may require you to be hospitalized for its treatment. Infections, if left untreated, can spread to other parts of the body and take longer to recover from.   Take care of your access at home. Don’t scratch or pick at your dialysis access site or scabs.  This could lead to an infection.

Don’t be afraid to ask dialysis staff to keep everything clean and as germ-free as possible as well.  They look after your well-being and should follow infection prevention protocols that prevail in the dialysis units.  

If you do hemodialysis at home keep your treatment area and access as clean as they would be in a dialysis clinic.  Wash your access site regularly with soap and water, and never use your cannulated arm for a blood pressure cuff or blood draws or other injections.   You and your care person should always use gloves for every occasion and call your doctor if you find signs of infection.

If you do peritoneal dialysis at home always wear a mask when starting and ending your treatment.  Redness, pain or drainage of the catheter exit site in your abdomen may be a sign of exit site infection.  Peritoneal infection is called peritonitis. To remain exit site infection free and peritonitis free depends on your cleanliness, care of the exit site as you were taught during your training and how well you can maintain a sterile area for your supplies and equipment.  Cleaning of the equipment should be done with a bleach and water solution. Dialysis ?uids should be stored in a cool and dry place. Patients need to be especially careful when taking a shower.  Use a bleach solution to clean shower heads, faucets and tub on a regular basis.  Always use a clean towel and washcloth.  Follow the procedures you learned during your training from your dialysis nurse.  Remember to be clean and wash your hands before starting a treatment.  Turning off the fan of the heater or air conditioner may prevent spreading the germs.  Peritoneal dialysis patients should check drainage bag for clarity of the solution.  A cloudy drainage solution and abdominal pain may be a sign of peritonitis. If this happens notify your dialysis nurse or doctor immediately.  Your doctor may order antibiotics to be given through the peritoneal fluid.