慢性肾脏病和终末期肾病患者艰难梭菌感染的高死亡风险：一项系统评价和荟萃分析
High Mortality Risk in Chronic Kidney Disease and End Stage Kidney Disease Patients with Clostridium Difficile Infection: A Systematic Review and Meta-analysis.
作者信息
Thongprayoon Charat, Cheungpasitporn Wisit, Phatharacharukul Parkpoom, Mahaparn Pailin, Bruminhent Jackrapong
机构信息
Division of Nephrology and Hypertension, Mayo Clinic, Rochester, Minnesota, USA.
Department of Internal Medicine, University of Minnesota, Minneapolis, Minnesota, USA.
出版信息
J Nat Sci. 2015 Apr;1(4).
BACKGROUND
The objective of this systematic review and meta-analysis was to evaluate the mortality risk in patients with chronic kidney diseases (CKD) and end stage renal disease (ESRD) requiring dialysis with infection (CDI).
METHODS
A literature search was performed from inception through February 2015. Studies that reported relative risks, odds ratios, or hazard ratios comparing the mortality risk of CKD or ESRD patients with CDI versus those without CDI were included. Pooled risk ratios (RRs) and 95% confidence intervals (CIs) were calculated using a random-effect, generic inverse variance method.
RESULTS
Four cohort studies with 8,214,676 patients were included in the meta-analysis. Pooled RR of mortality in CKD patients with CDI was 1.73 (95% CI 1.39-2.15). When meta-analysis was limited only to included studies with ESRD patients, the pooled RR of mortality in patients with ESRD was 2.15 (95% CI, 2.07-2.23).
CONCLUSION
This meta-analysis demonstrates significantly increased risks of mortality in CKD and ESRD patients with CDI. The magnitudes of mortality risk are high.
背景
本系统评价和荟萃分析的目的是评估慢性肾脏病（CKD）和终末期肾病（ESRD）需要透析且合并感染（CDI）患者的死亡风险。
方法
从研究起始至2015年2月进行文献检索。纳入报告了比较合并CDI的CKD或ESRD患者与未合并CDI患者死亡风险的相对风险、比值比或风险比的研究。使用随机效应、通用逆方差法计算合并风险比（RRs）和95%置信区间（CIs）。
结果
荟萃分析纳入了4项队列研究，共8,214,676例患者。合并CDI的CKD患者的死亡合并RR为1.73（95%CI 1.39 - 2.15）。当荟萃分析仅限于纳入的ESRD患者研究时，ESRD患者的死亡合并RR为2.15（95%CI，2.07 - 2.23）。
结论
本荟萃分析表明，合并CDI的CKD和ESRD患者的死亡风险显著增加。死亡风险程度很高。
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