Document 0500
 DOCN  M9460500
 TI    National surveillance of dialysis associated diseases in the United
       States, 1991.
 DT    9404
 AU    Tokars JI; Alter MJ; Favero MS; Moyer LA; Bland LA; Investigation and
       Prevention Branch, Hospital Infections Program,; Centers for Disease
       Control and Prevention, Atlanta, GA 30333.
 SO    ASAIO J. 1993 Oct-Dec;39(4):966-75. Unique Identifier : AIDSLINE
       MED/94169469
 AB    To determine trends in a number of hemodialysis associated diseases and
       practices, the Centers for Disease Control and Prevention in
       collaboration with the Health Care Financing Administration performed a
       mail survey of chronic hemodialysis centers in the United States in
       1991. Of 2,123 centers surveyed, 2,046 (96%), representing 155,877
       patients and 40,298 staff members, responded. The 1991 survey found that
       certain hemodialysis practices are increasing in frequency, including
       use of bicarbonate dialysate and high-flux dialysis and reuse of
       disposable dialyzers (in 1991, 71% of centers reused dialyzers).
       Hepatitis B surface antigen (HBsAg) was present at low frequency in
       patients (incidence = 0.2%, prevalence = 1.3%) and staff (incidence =
       0.04%, prevalence = 0.3%). Among centers that had > or = HBsAg positive
       patient, the incidence of hepatitis B virus (HBV) infection was lower in
       those centers that used a separate room for dialysis of HBsAg positive
       patients. Reuse of dialyzers, blood lines, transducer filters, or
       dialyzer caps was not associated with an increased risk of acquiring HBV
       infection among either patients or staff. Antibody to HBsAg was present
       in 21% of patients and 53% of staff, and was significantly related to
       levels of hepatitis B vaccine coverage. Pyrogenic reactions in the
       absence of septicemia were reported by 20% of centers and associated
       with the reuse of dialyzers. Human immunodeficiency virus (HIV) was
       known to be present in 1.2% of patients; 29% of centers reported
       providing hemodialysis to one or more HIV infected patients.
 DE    Fever/ETIOLOGY  Health Surveys  Hemodialysis/*ADVERSE EFFECTS  Hepatitis
       B/EPIDEMIOLOGY  Hepatitis B Antibodies/BLOOD  Hepatitis B
       Vaccines/IMMUNOLOGY  Hepatitis C/EPIDEMIOLOGY  Human  HIV
       Infections/EPIDEMIOLOGY  Incidence  Prevalence  United
       States/EPIDEMIOLOGY  JOURNAL ARTICLE

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