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The risk of infection-related hospitalization with decreased kidney function.
Tuesday,2012-11-06 12:25 America/Los_Angeles — eenright
| Title | The risk of infection-related hospitalization with decreased kidney function. |
| Publication Type | Journal Article |
| Year of Publication | 2012 |
| Authors | Dalrymple, LS, Katz, R, Kestenbaum, B, de Boer, IH, Fried, L, Sarnak, MJ, Shlipak, MG |
| Journal | Am J Kidney Dis |
| Volume | 59 |
| Issue | 3 |
| Pagination | 356-63 |
| Date Published | 2012 Mar |
| ISSN | 1523-6838 |
| Keywords | Aged, Cohort Studies, Female, Glomerular Filtration Rate, Hospitalization, Humans, Infection, Kidney, Male, Risk Factors |
| Abstract | <p><b>BACKGROUND: </b>Moderate kidney disease may predispose to infection. We sought to determine whether decreased kidney function, estimated by serum cystatin C level, was associated with the risk of infection-related hospitalization in older individuals.</p><p><b>STUDY DESIGN: </b>Cohort study.</p><p><b>SETTING & PARTICIPANTS: </b>5,142 Cardiovascular Health Study (CHS) participants with measured serum creatinine and cystatin C and without estimated glomerular filtration rate (eGFR) <15 mL/min/1.73 m(2) at enrollment.</p><p><b>PREDICTOR: </b>The primary exposure of interest was eGFR using serum cystatin C level (eGFR(SCysC)).</p><p><b>OUTCOME: </b>Infection-related hospitalizations during a median follow-up of 11.5 years.</p><p><b>RESULTS: </b>In adjusted analyses, eGFR(SCysC) categories of 60-89, 45-59, and 15-44 mL/min/1.73 m(2) were associated with 16%, 37%, and 64% greater risk of all-cause infection-related hospitalization, respectively, compared with eGFR(SCysC) ≥90 mL/min/1.73 m(2). When cause-specific infection was examined, eGFR(SCysC) of 15-44 mL/min/1.73 m(2) was associated with an 80% greater risk of pulmonary and 160% greater risk of genitourinary infection compared with eGFR(SCysC) ≥90 mL/min/1.73 m(2).</p><p><b>LIMITATIONS: </b>No measures of urinary protein, study limited to principal discharge diagnosis.</p><p><b>CONCLUSIONS: </b>Lower kidney function, estimated using cystatin C level, was associated with a linear and graded risk of infection-related hospitalization. These findings highlight that even moderate degrees of decreased kidney function are associated with clinically significant higher risks of serious infection in older individuals.</p> |
| DOI | 10.1053/j.ajkd.2011.07.012 |
| Alternate Journal | Am. J. Kidney Dis. |
| PubMed ID | 21906862 |
| PubMed Central ID | PMC3288732 |
| Grant List | N01 HC085086 / HC / NHLBI NIH HHS / United States R01 AG020098-01 / AG / NIA NIH HHS / United States R01 AG027002-01 / AG / NIA NIH HHS / United States R01 AG015928-02 / AG / NIA NIH HHS / United States N01 HC085081 / HC / NHLBI NIH HHS / United States AG-027002 / AG / NIA NIH HHS / United States R01 AG015928 / AG / NIA NIH HHS / United States U01 HL080295 / HL / NHLBI NIH HHS / United States N01 HC075150 / HC / NHLBI NIH HHS / United States N01-HC-85081 / HC / NHLBI NIH HHS / United States N01 HC015103 / HC / NHLBI NIH HHS / United States N01 HC085083 / HC / NHLBI NIH HHS / United States R56 AG020098 / AG / NIA NIH HHS / United States U01 HL080295-01 / HL / NHLBI NIH HHS / United States N01 HC085085 / HC / NHLBI NIH HHS / United States UL1 RR024146-01 / RR / NCRR NIH HHS / United States AG-20098 / AG / NIA NIH HHS / United States N01HC55222 / HL / NHLBI NIH HHS / United States N01-HC-85086 / HC / NHLBI NIH HHS / United States N01HC85086 / HL / NHLBI NIH HHS / United States AG-027058 / AG / NIA NIH HHS / United States N01 HC085082 / HC / NHLBI NIH HHS / United States N01-HC-85082 / HC / NHLBI NIH HHS / United States N01 HC085080 / HC / NHLBI NIH HHS / United States N01 HC-55222 / HC / NHLBI NIH HHS / United States N01 HC055222 / HC / NHLBI NIH HHS / United States R01 AG027058-01 / AG / NIA NIH HHS / United States N01-HC-85083 / HC / NHLBI NIH HHS / United States N01-HC-75150 / HC / NHLBI NIH HHS / United States N01-HC-85080 / HC / NHLBI NIH HHS / United States R01 HL080295 / HL / NHLBI NIH HHS / United States R01 AG027002 / AG / NIA NIH HHS / United States N01 HC085084 / HC / NHLBI NIH HHS / United States R01 AG020098 / AG / NIA NIH HHS / United States R01 AG023629-01 / AG / NIA NIH HHS / United States UL1 RR024146 / RR / NCRR NIH HHS / United States N01HC75150 / HL / NHLBI NIH HHS / United States N01-HC-85079 / HC / NHLBI NIH HHS / United States HL080295 / HL / NHLBI NIH HHS / United States N01-HC-85239 / HC / NHLBI NIH HHS / United States AG-023629 / AG / NIA NIH HHS / United States N01HC85079 / HL / NHLBI NIH HHS / United States N01 HC085079 / HC / NHLBI NIH HHS / United States R01 AG023629 / AG / NIA NIH HHS / United States R01 AG027058 / AG / NIA NIH HHS / United States N01 HC045133 / HC / NHLBI NIH HHS / United States N01 HC035129 / HC / NHLBI NIH HHS / United States R56 AG023629 / AG / NIA NIH HHS / United States |