Original InvestigationPathogenesis and Treatment of Kidney DiseaseThe Risk of Infection-Related Hospitalization With Decreased Kidney Function
Section snippets
Study Population
The CHS is a prospective cohort study of community-dwelling adults 65 years or older.10 Participants were randomly sampled from Health Care Financing Administration Medicare eligibility lists in Sacramento County, CA; Allegheny County, PA; Forsyth County, NC; and Washington County, MD. Participants initially were recruited between 1989 and 1990. Exclusion criteria included inability to provide informed consent or communicate with the interviewer, need of a proxy respondent for baseline
Results
Of the 5,888 original CHS participants, 80 were excluded for missing serum creatinine measurements; 651, for missing cystatin C values; and 15, for eGFR <15 mL/min/1.73 m2 or renal replacement therapy, resulting in a final study sample of 5,142. Participants excluded were more likely to be older, men, and nonblack and have prevalent diabetes and cancer and higher hemoglobin, IL-6, serum creatinine, and cystatin C concentrations. Excluded participants had lower body mass index and lower
Discussion
When kidney function was assessed by eGFRSCysC, we found that it was linearly associated with higher risk of infection-related hospitalization. Compared with participants with eGFRSCysC ≥90 mL/min/1.73 m2, participants with stage 3a CKD (eGFRSCysC, 45-59 mL/min/1.73 m2) had a nearly 40% increase in risk of infection-related hospitalization, and participants with stages 3b or 4 CKD (eGFRSCysC, 15-44 mL/min/1.73 m2) had a >60% increase in risk. These findings highlight that even moderately
Acknowledgements
Findings from this study were presented as a Poster Presentation at the American Society of Nephrology Renal Week in Denver, CO, on November 20, 2010.
Support: This research was supported by contracts N01-HC-85239, N01-HC-85079 through N01-HC-85086, N01-HC-35129, N01 HC-15103, N01 HC-55222, N01-HC-75150, N01-HC-45133, and grant HL080295 from the National Heart, Lung, and Blood Institute (NHLBI), with additional contribution from the National Institute of Neurological Disorders and Stroke.
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Cited by (94)
Kidney Function Measures and Mortality: A Mendelian Randomization Study
2024, American Journal of Kidney DiseasesStrategies to Prevent Infections in Dialysis Patients
2024, Seminars in NephrologyImpact of Chronic Renal Failure on Surgical Outcomes in Patients With Infective Endocarditis
2021, Annals of Thoracic SurgeryCitation Excerpt :Given that CRF is highly associated with cardiovascular disease,18 it may be expected that patients in the dialysis-treated group had higher rates of diabetes, dyslipidemia, hypertension, congestive heart failure, New York Heart Association functional class IV symptoms, cardiogenic shock, and arrhythmia preoperatively. CRF is also a known risk factor for infection,19 and dialysis-treated patients experienced higher rates of sepsis both before and after surgery. Nonetheless, the proportion of elective, urgent, and emergency operations was similar between the 2 groups, a finding suggesting that a history of renal failure did not affect the intent to treat or time until surgery.
Originally published online September 12, 2011.
Because the Editor-in-Chief and Deputy Editor recused themselves from consideration of this manuscript, the peer-review and decision-making processes were handled entirely by a Co-Editor (James S. Kaufman, MD, VA Boston Healthcare System) who served as Acting Editor-in-Chief. Details of the journal's procedures for potential editor conflicts are given in the Editorial Policies section of the AJKD website.