To investigate the distribution of pathogenic bacteria and prognosis in patients with diabetic nephropathy and non-diabetic nephropathy during maintenance hemodialysis, and to investigate the related influencing factors.

The clinical data of 248 patients undergoing maintenance hemodialysis complicated with infection in Nanjing Pukou Hospital and the First People’s Hospital of Huai’an from January 2014 to December 2018 were analyzed, retrospectively. They were divided into diabetic nephropathy group (125 cases) and non-diabetic nephropathy group (123 cases) according to whether complicated with diabetes. The infection, pathogen distribution and prognosis of patients in both groups were compared, respectively; and the patient’s gender, age, dialysis, dialysis pathway, anemia and hypoproteinemia, multi-drug resistant bacteria infection, diabetes, oxidized protein product (AOPP) and C-reactive protein (CRP) levels and other factors were also collected, then the prognostic factors were investigated by single factor analysis and Logistic regression analysis.

The patients in diabetic nephropathy group and non-diabetic nephropathy group had no significant difference in the composition of respiratory (χ² = 2.005, P = 0.157), urinary tract (χ² = 0.781, P = 0.277), digestive tract (χ² = 1.152, P = 0.283), venous catheter (χ² = 0.089, P = 0.765) and skin and soft tissue (χ² = 0.518, P = 0.472). The composition ratio of bacteria, Gram-positive bacteria and fungi in two group was not significantly different (χ² = 1.576, P = 0.455), and there was no significant difference in the propotion of Gram-negative bacteria (χ² = 0.747, P = 0.862), Gram-positive bacteria (χ² = 0.524, P = 0.469) and fungi (χ² = 0.036, P = 0.851). The number of cases with good prognosis and poor prognosis between the two groups was significantly different (χ² = 1.576, P = 0.455). According to univariate analysis, there were significant differences between the two groups with good prognosis and poor prognosis in terms of anemia (χ² = 5.250, P = 0.022), hypoalbuminemia (χ² = 5.706, P = 0.017), multi-drug resistant bacteria infection (χ² = 5.706, P = 0.001), diabetes (χ² = 2.962, P = 0.085), AOPP (t = 18.189, P < 0.001) and CRP levels (t = 14.466, P < 0.001). The above indexes were enrolled in Logistic multivariate regression analysis model, which showed that multidrug-resistant bacterial infection (χ² = 9.964, P = 0.001), diabetes (χ² = 7.845, P = 0.016), and high levels of AOPP (χ² = 6.046, P = 0.028) were all independent risk factors affecting the prognosis of patients with concurrent MHD infection.

The patients of diabetic nephropathy and non-diabetic nephropathy with maintenance hemodialysis complicated with infection had no significant differences in the infection site and the distribution of pathogenic bacteria, but the latter had a better prognosis than the former, which was related to multi-drug resistant bacteria infection, diabetes prevalence and AOPP level.