National Taiwan University Hospital, Hsin-Chu Branch, Department of Internal Medicine, Hsin-Chu City, Taiwan.
National Taiwan University, The Graduate Institute of Medical Genomics and Proteomics, Taipei, Taiwan.
Sci Rep. 2020 Mar 11;10(1):4475. doi: 10.1038/s41598-020-61144-6.
Patients with chronic kidney disease (CKD) are at high risk of infection, but whether the risks are attenuated in different patient groups remains unclear. This study enrolled participants with CKD stages 1-3 in the New Taipei City Health Screening Program between 2005 and 2008. A proportional hazard regression model was employed to calculate the hazard ratios (HRs) and 95% confidence intervals (CIs) for infection-related hospitalization and mortality in younger (<50-year-old) and older (≥50-year-old) CKD patients. Of 119,871 adults, there were 14,207 cases of first hospitalization for infection during a median follow-up of 8.14 years; 45.5% of these cases were younger patients. Unlike CKD stage 1 and 2 patients, the risk of infection-related hospitalization in younger CKD stage 3 patients is as high as for older CKD stage 3 patients. Proteinuria increases the risk of infection-related hospitalization independent of estimated glomerular filtration rate (eGFR) levels in older CKD patients but this relationship is weak in their younger counterparts. In conclusion, the risk of infection-related hospitalization is high in subgroups of CKD patients. Prevention and treatment of infections in these patients merit more attention.
患有慢性肾脏病(CKD)的患者感染风险较高,但不同患者群体的风险是否降低仍不清楚。本研究纳入了 2005 年至 2008 年新台北市健康筛查计划中 1-3 期 CKD 患者。采用比例风险回归模型计算了年轻(<50 岁)和老年(≥50 岁)CKD 患者感染相关住院和死亡的风险比(HR)和 95%置信区间(CI)。在 119871 名成年人中,中位随访 8.14 年后有 14207 例首次因感染住院;其中 45.5%为年轻患者。与 CKD 1 期和 2 期患者不同,年轻 CKD 3 期患者感染相关住院的风险与老年 CKD 3 期患者一样高。在老年 CKD 患者中,蛋白尿增加感染相关住院的风险独立于估计肾小球滤过率(eGFR)水平,但在年轻患者中这种关系较弱。总之,CKD 患者亚组的感染相关住院风险较高。这些患者的感染预防和治疗需要更多关注。