Most Read Articles
11 Dec 2017
Combining the DASH (Dietary Approaches to Stop Hypertension) diet with low sodium intake reduces systolic blood pressure (SBP) in individuals with pre- and stage 1 hypertension, with progressively higher reductions at greater levels of baseline SBP, a recent study has shown.
Tristan Manalac, 5 days ago
Major depressive disorder (MDD) appears to be more prevalent in females than in males, particularly in those who are divorced or widowed, a recent study from Singapore has found.
6 days ago
Tadalafil may not be effective for reducing the decline in ambulatory ability in boys with Duchenne muscular dystrophy (DMD), as shown in a recent study.
01 Dec 2017
At a symposium during the 25th Congress of the Obstetrical and Gynaecological Society of Malaysia in Kuala Lumpur, Professor Susan Davis discussed the unique implications of women living decades beyond menopause, and how healthcare professionals can best manage menopausal symptoms in the short and long term.

CKD ups mortality in infection-related hospitalization

Tristan Manalac
29 Sep 2017

Chronic kidney disease (CKD) is associated with poorer in-hospital outcomes in infection-related hospitalization (IRH) patients, a new study from China has found.

“Our study is the first to quantify the spectrum of infections and associated in-hospital outcomes of IRH in patients with and without CKD in China,” said researchers.

“We report that CKD patients hospitalized with infections have increased rates of deaths and intensive care unit (ICU) admissions, resulting in higher health care resource consumption,” they added.

In the study sample of 6,283 IRH patients (median age 63 [49 to 77] years; 49.7 percent female), 1,935 had CKD while 4,348 did not. Community-acquired IRHs (CAIRH; 58.8 percent; n=3,697) constituted most of the IRH cases. This was followed by undefined (UIRH; 37.7 percent; n=2,371) and healthcare-acquired (HAIRH, 2.6 percent; n=162) IRH cases. Patients with both CAIRH and HAIRH were the smallest proportion (0.8 percent; n=53). [Sci Rep 2017;7:11530]

The mortality rate in the CKD and non-CKD patients was calculated to be 5.9 (n=115) and 3.8 (n=166) percent, respectively, with the difference reaching statistical significance (p<0.001). In the fully adjusted model, the odds of in-hospital death were significantly higher in CKD than in non-CKD patients (odds ratio [OR], 1.41; 95 percent CI, 1.02 to 1.96; p=0.04).

Analysis of the CAIRH subgroup showed that CKD also elevated the risk of in-hospital death, although the effect did not reach significance (OR, 1.34; 0.86 to 2.09; p=0.20). In contrast, CKD insignificantly decreased the risk of mortality in HAIRH patients (OR, 0.87; 0.27 to 2.70; p=0.79).

While the detrimental effect of CKD on the mortality of IRH patients might be explained by older age and other comorbidities, controlling for these did not affect the interaction, suggesting that other factors were involved.

These factors may include “poorer responses to treatment, immune dysfunction with increased susceptibility to infections, and a higher incidence of dehydration that may induce acute kidney injury during infection,” according to the researchers. [Adv Chronic Kidney Dis 2006;13:199-204; Clin J Am Soc Nephro 2008;3:1526-1533]

Admission into the ICU was also higher in CKD patients than in non-CKD patients (12.2 vs 5.5 percent). This was true across the overall sample (OR, 2.18; 1.64 to 2.91; p<0.001), among CAIRH patients (OR, 2.01; 1.34 to 3.02; p=0.001) and among HAIRH patients (OR, 2.48; 1.08 to 5.70; p=0.03), even after adjusting for age, sex and comorbidities. Adjusting for pneumonia did not attenuate the statistically significant interactions.

Moreover, CKD patients had significantly longer duration of stay than non-CKD patients (median length 11 vs 10 days; p<0.001). CKD patients also incurred a 20-percent increase in total medical expenses compared with non-CKD patients.

“In conclusion, our findings highlight the poorer clinical outcomes and higher healthcare resource consumption of hospitalizations for patients with infections who also have CKD,” summarized researchers.

“For patients with CKD, infection prevention strategies should focus on respiratory tract infections and genitourinary tract infections. These patients need to be carefully monitored to prevent modifiable adverse outcomes,” they recommended. 

Digital Edition
Asia's trusted medical magazine for healthcare professionals. Get your MIMS Doctor - Malaysia digital copy today!
DOWNLOAD
Editor's Recommendations
Most Read Articles
11 Dec 2017
Combining the DASH (Dietary Approaches to Stop Hypertension) diet with low sodium intake reduces systolic blood pressure (SBP) in individuals with pre- and stage 1 hypertension, with progressively higher reductions at greater levels of baseline SBP, a recent study has shown.
Tristan Manalac, 5 days ago
Major depressive disorder (MDD) appears to be more prevalent in females than in males, particularly in those who are divorced or widowed, a recent study from Singapore has found.
6 days ago
Tadalafil may not be effective for reducing the decline in ambulatory ability in boys with Duchenne muscular dystrophy (DMD), as shown in a recent study.
01 Dec 2017
At a symposium during the 25th Congress of the Obstetrical and Gynaecological Society of Malaysia in Kuala Lumpur, Professor Susan Davis discussed the unique implications of women living decades beyond menopause, and how healthcare professionals can best manage menopausal symptoms in the short and long term.