CKD Is Associated With Some Community-Acquired Infections

A recent study showed that community-acquired infections, such as lower respiratory tract infections, urinary tract infections, and sepsis, are associated with mild to severe chronic kidney disease (CKD). However, nervous system and upper respiratory tract infections were not found to be associated with CKD.

Community-acquired infections are common and contribute to higher health care costs and adverse outcomes. Therefore, the researchers aimed to assess their impact particularly among patients with CKD.
_____________________________________________________________________________________________________________________________________

RELATED CONTENT
CKD Is Common Among Patients With Multiple Chronic Conditions
Intensive vs Standard BP Control: Which Is Better for CKD Progression?
_____________________________________________________________________________________________________________________________________

For their study, the researchers evaluated 1,139,470 health care users from the Stockholm CREAtinine Measurements Project. Participants were a mean age of 52 years, and 53% of participants were women.

Over 12 months, the associations between estimated glomerular filtration rate (eGFR) and the risk of overall and major types of infections were measured.

Ultimately, the researchers recorded an incidence of 106,807 infections throughout 1,128,313 person-years. Participants with low eGFR (<30 ml/min/1.73 m2) had experienced a higher rate of infection vs those with a normal eGFR (90-104 ml/min/1.73 m²).

Those in the lowest eGFR bracket had the highest incidence rate of infection (1.53) compared with those with an eGFR of 30 to 59 ml/min/1.73 m² (1.08) and a normal eGFR.

The researchers found that the relative proportions of lower respiratory tract infections, urinary tract infections, and sepsis were increasingly higher along those with lower eGFR. Additionally, the differences in the incidence of infections associated with eGFR were largely consistent for most types of infections. However, no associations were observed between eGFR and nervous system and upper respiratory tract infections, the researchers noted.

“This region-representative health care study finds an excess community-acquired infections incidence in individuals with mild to severe CKD,” the researchers concluded. “Lower respiratory tract infection, urinary tract infection, and sepsis are major infections in CKD.”

—Christina Vogt

Reference:

Xu H, Gasparini A, Ishigami J, et al. eGFR and the risk of community-acquired infections [Published online August 2017]. Clin J Am Soc Nephrol. doi:10.2215/​CJN.00250117.