Infection and Dysfunction of Hemodialysis Catheters in Adults: A Systematic Review of Chronic Hemodialysis Evidence Published from 2014 to 2025

Infection and dysfunction are clinically important complications of hemodialysis catheters, but differences in outcome measurement complicate comparisons of their frequency. This systematic review examined selected observational evidence in adults receiving chronic intermittent hemodialysis, with first electronic publication during 2014-2025. PubMed searches, supplemented by previously identified publications and reference checking, informed selection of 20 study units. Extraction distinguished catheter type, infection category, clinical dysfunction, removal-related outcomes, measurement unit, and follow-up. Synthesis was study-specific, and no meta-analysis was performed. Gorsane reported a higher catheter-level proportion for infection than dysfunction, whereas malfunction predominated in Hu. In Momeni, the Results section reported more patients with infection than dysfunction, but the Discussion described infection episodes; this comparison is interpreted using the Results-reported patient counts, not as an episode rate. Studies restricted to infection, access abandonment, or causes among dysfunctional cases answered different questions and were interpreted separately. The synthesis identified which comparisons could be made within cohorts and which were restricted by diagnostic specificity, repeated devices, selection of removed catheters, or unequal follow-up. These findings support interpretation of reported complication frequencies through an explicit framework linking each estimate to its population, event definition, denominator, and observation period. For Libyan dialysis services, the review provides a basis for selecting surveillance fields and interpreting international evidence; local rates require local data.