Cohen-Hagai Keren, Rozenberg Ilan, Korzets Ze'ev, Zitman-Gal Tali, Einbinder Yael, Benchetrit Sydney
Department of Nephrology and Hypertension, Meir Hospital, Kfar Saba, Israel.
Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Isr Med Assoc J. 2016 Sep;18(9):557-560.
Upper respiratory tract infection (URTI) occurs frequently in the general population and is considered a benign self-limited disease. Dialysis patients constitute a high risk population whose morbidity and mortality rate as a result of URTI is unknown.
To assess the local incidence, morbidity and mortality of URTI in dialysis patients compared to the general population.
In this retrospective cohort study we reviewed the charts of all chronic dialysis patients diagnosed with URTI at Meir Medical Center, Kfar Saba, Israel during the 2014-2015 winter season.
Among 185 dialysis patients, 40 were found to be eligible for the study. The average age was 66.1 ± 15.7 years, and the co-morbidity index was high. Influenza A was the most common pathogen found, followed by rhinovirus, respiratory syncytial virus and para-influenza. Of the 40 patients 21 (52.5%) developed complications: pneumonia in 20%, hospitalization in 47.5%, and respiratory failure requiring mechanical ventilation in 12.5%. Overall mortality was 10%. General population data during the same seasonal period showed a peak pneumonia incidence of 4.4% compared to 20% in the study population (P < 0.0001).
The study findings show that compared to the general population, URTI in dialysis patients is a much more severe disease and has a higher complication rate. Influenza A, the most common pathogen, is associated with a worse prognosis.
上呼吸道感染（URTI）在普通人群中频繁发生，被认为是一种良性自限性疾病。透析患者构成了一个高危人群，因URTI导致的发病率和死亡率尚不清楚。
评估透析患者中URTI的局部发病率、发病率和死亡率，并与普通人群进行比较。
在这项回顾性队列研究中，我们查阅了2014 - 2015年冬季在以色列卡法萨巴的梅尔医疗中心被诊断为URTI的所有慢性透析患者的病历。
在185名透析患者中，40名被认为符合研究条件。平均年龄为66.1±15.7岁，合并症指数较高。甲型流感是最常见的病原体，其次是鼻病毒、呼吸道合胞病毒和副流感病毒。40名患者中有21名（52.5%）出现并发症：肺炎占20%，住院占47.5%，呼吸衰竭需要机械通气占12.5%。总体死亡率为10%。同一季节普通人群的数据显示肺炎发病率峰值为4.4%，而研究人群中为20%（P < 0.0001）。
研究结果表明，与普通人群相比，透析患者中的URTI是一种更为严重的疾病，并发症发生率更高。最常见的病原体甲型流感与更差的预后相关。
