Dudzicz Sylwia, Wiecek Andrzej, Adamczak Marcin
Department of Nephrology, Transplantation and Internal Medicine, Medical University of Silesia, 40-027 Katowice, Poland.
J Clin Med. 2021 Jan 7;10(2):196. doi: 10.3390/jcm10020196.
Increased incidence of infection (CDI), occurrence of severe and complicated CDI, and more frequent occurrence of drug-resistant, recurrent or non-hospital CDI has become a worldwide clinical problem. CDI is more common in patients with chronic kidney disease (CKD) than in the general population. CDI seems to be associated with frequent hospitalization, frequently used antibiotic therapy, dysbiosis, and abnormalities of the immune system observed in CKD patients. Dysbiosis is a common disorder found in CKD patients. It may be related to insufficient fiber content in the diet, reduced amount of consumed fluids and often reduced physical activity, constipation, impaired gastrointestinal motility, multidrug pharmacotherapy, and uremic milieu in CKD stage 5. In patients with CKD the clinical manifestations of CDI are similar to the general population; however, more frequent recurrence of CDI and higher prevalence of severe CDI are reported. Moreover, the increase in CDI related mortality is observed more in CKD patients than in the general population. The aim of this review paper is to summarize the current knowledge concerning the epidemiology, pathogenesis, clinical picture, and prevention and treatment in CKD patients.
艰难梭菌感染（CDI）发病率上升、严重及复杂性CDI的出现，以及耐药、复发性或非医院获得性CDI的更频繁发生已成为一个全球性的临床问题。CDI在慢性肾脏病（CKD）患者中比在普通人群中更为常见。CDI似乎与CKD患者频繁住院、频繁使用抗生素治疗、生态失调以及免疫系统异常有关。生态失调是CKD患者中常见的病症。它可能与饮食中纤维含量不足、液体摄入量减少、身体活动常常减少、便秘、胃肠动力受损、多药药物治疗以及CKD 5期的尿毒症环境有关。在CKD患者中，CDI的临床表现与普通人群相似；然而，据报道CDI更频繁复发且严重CDI的患病率更高。此外，观察到CDI相关死亡率在CKD患者中比在普通人群中增加得更多。这篇综述文章的目的是总结目前关于CKD患者的流行病学、发病机制、临床表现以及预防和治疗的知识。
