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Tunneled Right Atrial Catheter Infection Presenting as Renal Failure

Department of General Surgery, The Cleveland Clinic Foundation. Ohio

Douglas L. Seidner, MD

Department of General Surgery, The Cleveland Clinic Foundation. Ohio, Department of Gastroenterology, The Cleveland Clinic Foundation. Ohio

Ezra Steiger, MD

Department of General Surgery, The Cleveland Clinic Foundation. Ohio

Phillip M. Hall, MD

Department of Nephrology and Hypertension, The Cleveland Clinic Foundation. Ohio

Joseph V. Nally, MD

Department of Nephrology and Hypertension, The Cleveland Clinic Foundation. Ohio

We report two cases of progressive renal failure secondary to membranoproliferative glomerulonephritis associated with subclinical septicemia from a tunneled right atrial catheter used for home parenteral nutrition administration. Although the occurrence of line infection and septicemia is a common complication of central venous catheters, a review of the literature reveals only one case report of renal failure secondary to an infected implanted central venous device. Both patients presented with azotemia and had biopsy-proven membranoproliferative glomerulonephritis, accompanied by leukocytoclastic vasculitis. In both cases, removal of the right atrial catheter and prolonged antibiotic therapy was effective in resolving the ongoing infection and resulted in marked improvement in renal function. A high index of suspicion for catheter sepsis should be maintained in patients with tunneled right atrial catheters presenting with subacute renal failure. (Journal of Parenteral and Enteral Nutrition 23:363-365, 1999)

Journal of Parenteral and Enteral Nutrition, Vol. 23, No. 6, 363-365 (1999)
DOI: 10.1177/0148607199023006363


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