Objective To analyze the clinical features of hemodialysis patients complicated by infective endo- carditis. Methods The clinical features of six such patients admitted to Peking Union Medical College Hospital during the year 1990 to 2009 were analyzed. All of them were diagnosed based on Chinese Children Diagnostic Criteria for Infective Endocarditis. Results The average age of the six patients was 52.319.3 years old. Four were males. Vascular accesses at the onset of infective endocarditis were as follows: permanent catheters in three

temporary catheters in two

and arteriovenous fistula in one. Three were found with mitral valve involvement

two with aortic valve involvement

and one with both. Five vegetations were found by transthoracic echocardiography

and one by transesophageal echocardiography. Four had positive blood culture results. The catheters were all removed. Four of the patients were improved by antibiotics treatment

in which two were still on hemodialysis in the following 14-24 months and the other two were lost to follow-up. One patient received surgery

but died of heart failure after further hemodialysis for three months. One was well on maintenance hemodialysis for three months after surgery. Conclusions Infective endocarditis should be suspected when hemodialysis patients suffer from long-term fever

for which prompt blood culture and transthoracic echocardiography confirmation could be performed. Transesophageal echocardiography could be considered even when transthoracic echocardiography produces negative findings. With catheters removed

full course of appropriate sensitive antibiotics and surgery if indicated could improve the outcome of chronic hemodialysis patients complicated by infective endocarditis.