目的  总结维持性血液透析(hemodialysis, HD)患者发生感染性心内膜炎(infective endocarditis，IE)的临床特征及诊疗经验，为临床早期识别和管理提供依据。 方法  回顾性分析2020年6月─2024年10月河北医科大学第一医院肾内科收治的8例血液透析相关感染性心内膜炎(hemodialysis-related infective endocarditis，HD-IE)患者。分析并总结人口学特征、临床特点、治疗方案、转归等信息。 结果  8例患者均为男性，年龄49.5(41.0，59.5)岁，透析龄48(15，96)个月。常见首发症状为发热(75.0%)，其次为呼吸困难(25.0%)。血培养阳性6例(75.0%)。4例患者血管通路为带隧道带涤纶套导管(tunneled cuffed catheter，TCC)，确诊HD-IE后均及时拔除导管。2例接受心瓣膜置换手术。住院病死率62.5%(5/8)，3例单纯右心受累患者均存活。 结论  HD-IE病死率高，临床表现缺乏特异性。金黄色葡萄球菌是主要致病菌。右心感染性心内膜炎预后优于左心感染性心内膜炎。内科治疗效果不佳或伴严重并发症者，应及时评估外科手术干预。

Objective To summarize the clinical features and management experience of infective endocarditis (IE) in maintenance hemodialysis (MHD) patients, and to provide features for early recognition and treatment of IE.  Methods  We retrospectively analyzed 8 patients with MHD-related infective endocarditis (MHD-IE) admitted to Department of Nephrology, the First Hospital of Hebei Medical University between June 2020 and October 2024. Demographic data, clinical characteristics, treatments, and outcomes were reviewed.  Results  All patients were males, with a median age of 49.5 years (IQR 41.0～59.5) and a median dialysis vintage of 48 months (IQR 15～96). Fever (75.0%) was the most common presenting symptom, followed by dyspnea (25.0%). Blood cultures were positive in 6 patients (75.0%). All of the 4 patients with tunneled cuffed catheter-related IE underwent prompt removal of the catheters after diagnosis. Two patients received valve replacement surgery. In-hospital mortality was 62.5% (5/8). All of the 3 patients with isolated right-sided IE survived.   Conclusion  MHD-IE is associated with high mortality and nonspecific clinical presentation. Staphylococcus aureus is the major pathogen. Right-sided infective endocarditis (LSIE) has a better prognosis than left-sided infective endocarditis(LSIE). IE patients with inadequate response to medical therapy or severe complications should be promptly evaluated for the possibility of surgical intervention.