Abstract: Objective To systematically review the incidence and risk factors for catheter-related bloodstream infection (CRBSI) in hemodialysis patients undergoing tunneled central venous catheterization.  Methods  PubMed, Web of science, Embase, Cochrane Library, CBM, WanFang Data, VIP and CNKI databases from the establishment of the database to September 2022 were searched for clinical studies about the incidence and/or risk factors of CRBSI. R software (version 4.1.2) was used for meta-analysis of single-group rate and risk factors.  Results   A total of 21 studies were included, including 6,758 patients undergoing hemodialysis through tunneled central venous catheters. Meta-analysis showed that the pooled incidence of CRBSI was 14.5%, the incidence was 28.9% in European population (95% CI：16.2%～43.5%), and the incidence was 26.3% from case-control study (95% CI：14.1%～40.7%). The incidence was 22.2% (95% CI：14.5%, 31.0%) in patients aged≥60 years, and 28.2% (95% CI：2.5%～67.2%) in patients with catheterization duration of >24 months. Age≥60 years old (OR=1.85, 95% CI：1.29～2.64), albumin <30g/L (OR=2.12, 95% CI：1.40～3.22), femoral vein catheterization (OR=2.17, 95% CI：1.24～3.80), diabetes mellitus (OR=1.82, 95% CI：1.37～2.40), and catheterization period≥4 weeks (OR=2.04, 95% CI：1.22～3.41) were the important risk factors for CRBSI in hemodialysis patients undergoing tunneled central venous catheterization.  Conclusion The incidence of CRBSI is higher in patients undergoing hemodialysis through tunneled central venous catheter. Age≥60 years, albumin <30g/L, femoral vein catheterization, diabetes mellitus, catheterization period≥4 weeks are the important risk factors for CRBSI.

Key words: Hemodialysis, Tunneled central venous catheter, Catheter-associated bloodstream infection, Incidence, Risk factor