TY - JOUR T1 - Septic arthritis in the end-stage renal disease population JF - Journal of Investigative Medicine JO - J Investig Med SP - 383 LP - 390 DO - 10.1136/jim-2021-001869 VL - 70 IS - 2 AU - Lorry Aitkens AU - Matthew Winn AU - Jennifer L Waller AU - Lu Huber AU - Stephanie L Baer AU - Azeem Mohammed AU - Mufaddal Kheda AU - Sarah Tran AU - Budder Siddiqui AU - Sandeep Padala AU - Rhonda E Colombo AU - Wendy B Bollag Y1 - 2022/02/01 UR - http://hw-f5-jim.highwire.org/content/70/2/383.abstract N2 - Septic arthritis is important to consider in any patient who presents with joint pain because it is a medical emergency with an 11% fatality rate. Diagnosis and treatment may improve prognosis; however, many patients do not regain full joint function. In patients with end-stage renal disease (ESRD), immune dysfunction due to uremia and chronic vascular access leads to increased risk of infection. We examined the incidence, risk factors and sequelae of septic arthritis in a cohort of hemodialysis patients. The US Renal Data System was queried for diagnoses of septic arthritis and selected sequelae using International Statistical Classification of Diseases and Related Health Problems-9 and Current Procedural Terminology-4 codes in patients who initiated hemodialysis between 2005 and 2010. Multivariable logistic regression was used to determine potential risk factors for septic arthritis and its sequelae. 7009 cases of septic arthritis were identified, an incidence of 514.8 per 100,000 persons per year. Of these patients, 2179 were diagnosed with a documented organism within 30 days prior to or 14 days after the septic arthritis diagnosis, with methicillin-resistant Staphylococcus aureus infections (57.4%) being the most common. Significant risk factors for septic arthritis included history of joint disease, immune compromise (diabetes, HIV, cirrhosis), bacteremia and urinary tract infection. One of the four sequelae examined (joint replacement, amputation, osteomyelitis, Clostridioides difficile infection) occurred in 25% of septic arthritis cases. The high incidence of septic arthritis and the potential for serious sequelae in patients with ESRD suggest that physicians treating individuals with ESRD and joint pain/inflammation should maintain a high clinical suspicion for septic arthritis.Data are available in a public, open access repository. The data underlying this article are available in the USRDS Database, at https://www.usrds.org/for-researchers/simple-data-requests/ and can be accessed by submitting a Simple Data Request form. ER -