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Because endocarditis is one of the most serious complications of hemodialysis catheters, it is vital to recognize this problem. The aim of this study was to examine the prevalence of focal endocarditis related to hemodialysis catheters and to identify risk factors for the development of endocarditis. A single-center, retrospective case series was carried out at a university hospital. The study included all patients who had undergone hemodialysis by means of catheters and who had been treated at the University Hospital of Zurich between January 1, 1998, and December 31, 2002. Patients were identified via the databases of the microbiology and hemodialysis units. A total of 496 cases of hemodialysis catheter use were registered. Thirty-two cases (6.4%) of catheter-related focal infective endocarditis were observed. The subgroup of 75 focal endocarditis cases that were detected by echocardiography or by a cardiac procedure had a significantly greater prevalence of hemodialysis catheters with an insertion duration of 12 months or longer compared with the subgroup of 257 focal cases identified only by clinical suspicion (22.1% vs. 5.9%; P =.01). Additionally, all six cases of culture-positive and clinically suspected but echocardiographically unsuspected focal infective endocarditis occurred in patients who had undergone dialysis by means of a tunneled catheter for 12 months or more. None of these factors were identified by the multivariate analysis. Catheter-related focal infective endocarditis occurs in a small but significant proportion of the patients undergoing hemodialysis by means of a long-term catheter. Because of the potential severity of the disease, this situation mandates a detailed analysis of the frequency and duration of catheter placement. in the set $\{1, 2, \dots, n+r\}$. We need to use induction in order to show that $f_{i}(k_{i
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