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Chronic Kidney Disease and Risk of Death from Infection

Background: Infection, bacteremia and sepsis are major sources of morbidity and mortality in patients with end-stage renal disease. This study sought to determine the association between predialysis chronic kidney disease (CKD) and infection-related mortality. Methods: We analyzed participants in th... Full description

Journal Title: American journal of nephrology 2011, Vol.34 (4), p.330-336
Main Author: Wang, Henry E
Other Authors: Gamboa, Christopher , Warnock, David G , Muntner, Paul
Format: Electronic Article Electronic Article
Language: English
Subjects:
Quelle: Alma/SFX Local Collection
Publisher: Basel, Switzerland: S. Karger AG
ID: ISSN: 0250-8095
Link: https://www.ncbi.nlm.nih.gov/pubmed/21860228
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title: Chronic Kidney Disease and Risk of Death from Infection
format: Article
creator:
  • Wang, Henry E
  • Gamboa, Christopher
  • Warnock, David G
  • Muntner, Paul
subjects:
  • Aged
  • Chronic kidney disease
  • Female
  • Glomerular Filtration Rate
  • Humans
  • Incidence
  • Infection
  • Infection - complications
  • Infection - mortality
  • Kidney Failure, Chronic - complications
  • Kidney Failure, Chronic - mortality
  • Kidney Failure, Chronic - pathology
  • Male
  • Middle Aged
  • Mortality
  • Multivariate Analysis
  • Nutrition Surveys
  • Oriented
  • Original Report
  • Original Report: Patient-Oriented, Translational Research
  • Patient
  • Patient-Oriented, Translational Research
  • Proportional Hazards Models
  • Risk
  • Sepsis
  • Translational Research
  • Treatment Outcome
  • United States
ispartof: American journal of nephrology, 2011, Vol.34 (4), p.330-336
description: Background: Infection, bacteremia and sepsis are major sources of morbidity and mortality in patients with end-stage renal disease. This study sought to determine the association between predialysis chronic kidney disease (CKD) and infection-related mortality. Methods: We analyzed participants in the Third National Health and Nutrition Examination Survey (NHANES III). The study included adults ≧45- years-old without end-stage renal disease. Estimated glomerular filtration rate (eGFR) was categorized as ≧60, 45–59.9 and
language: eng
source: Alma/SFX Local Collection
identifier: ISSN: 0250-8095
fulltext: fulltext
issn:
  • 0250-8095
  • 1421-9670
url: Link


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creatorcontribWang, Henry E ; Gamboa, Christopher ; Warnock, David G ; Muntner, Paul
descriptionBackground: Infection, bacteremia and sepsis are major sources of morbidity and mortality in patients with end-stage renal disease. This study sought to determine the association between predialysis chronic kidney disease (CKD) and infection-related mortality. Methods: We analyzed participants in the Third National Health and Nutrition Examination Survey (NHANES III). The study included adults ≧45- years-old without end-stage renal disease. Estimated glomerular filtration rate (eGFR) was categorized as ≧60, 45–59.9 and <45 ml/min per 1.73 m2, and urinary albumin-to-creatinine ratio (ACR) as <30, 30–299.9 and ≧300 mg/g. The study identified infection-related mortality, including septicemia, respiratory, abdominal and gastrointestinal, cardiac, kidney and genitourinary, neurologic, and other infections over a median of 13 years using the National Death Index. Results: Of 7,400 participants included in the study, 206 died from infections. Compared to individuals with eGFR ≧60 ml/min per 1.73 m2, infection-related mortality was higher for those with lower eGFR [adjusted HR = 1.36 (95% CI: 0.81, 2.30) and 2.36 (1.04, 5.38) for eGFR of 45–59.9 and <45 ml/min per 1.73 m2, respectively; p trend = 0.06]. Compared to individuals with ACR <30 mg/g, infection-related mortality was higher for ACR levels of 30–299 and ≧300 mg/g [adjusted HR = 1.68 (95% CI: 0.97, 2.92) and 2.84 (0.92, 8.74), p trend = 0.02]. Conclusions: Reduced eGFR and albuminuria are associated with increased risk for infection-related mortality. Efforts are needed to reduce its incidence and mitigate the effects of infections among individuals with CKD.
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subjectAged ; Chronic kidney disease ; Female ; Glomerular Filtration Rate ; Humans ; Incidence ; Infection ; Infection - complications ; Infection - mortality ; Kidney Failure, Chronic - complications ; Kidney Failure, Chronic - mortality ; Kidney Failure, Chronic - pathology ; Male ; Middle Aged ; Mortality ; Multivariate Analysis ; Nutrition Surveys ; Oriented ; Original Report ; Original Report: Patient-Oriented, Translational Research ; Patient ; Patient-Oriented, Translational Research ; Proportional Hazards Models ; Risk ; Sepsis ; Translational Research ; Treatment Outcome ; United States
ispartofAmerican journal of nephrology, 2011, Vol.34 (4), p.330-336
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descriptionBackground: Infection, bacteremia and sepsis are major sources of morbidity and mortality in patients with end-stage renal disease. This study sought to determine the association between predialysis chronic kidney disease (CKD) and infection-related mortality. Methods: We analyzed participants in the Third National Health and Nutrition Examination Survey (NHANES III). The study included adults ≧45- years-old without end-stage renal disease. Estimated glomerular filtration rate (eGFR) was categorized as ≧60, 45–59.9 and <45 ml/min per 1.73 m2, and urinary albumin-to-creatinine ratio (ACR) as <30, 30–299.9 and ≧300 mg/g. The study identified infection-related mortality, including septicemia, respiratory, abdominal and gastrointestinal, cardiac, kidney and genitourinary, neurologic, and other infections over a median of 13 years using the National Death Index. Results: Of 7,400 participants included in the study, 206 died from infections. Compared to individuals with eGFR ≧60 ml/min per 1.73 m2, infection-related mortality was higher for those with lower eGFR [adjusted HR = 1.36 (95% CI: 0.81, 2.30) and 2.36 (1.04, 5.38) for eGFR of 45–59.9 and <45 ml/min per 1.73 m2, respectively; p trend = 0.06]. Compared to individuals with ACR <30 mg/g, infection-related mortality was higher for ACR levels of 30–299 and ≧300 mg/g [adjusted HR = 1.68 (95% CI: 0.97, 2.92) and 2.84 (0.92, 8.74), p trend = 0.02]. Conclusions: Reduced eGFR and albuminuria are associated with increased risk for infection-related mortality. Efforts are needed to reduce its incidence and mitigate the effects of infections among individuals with CKD.
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7Infection - complications
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21Patient-Oriented, Translational Research
22Proportional Hazards Models
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26Treatment Outcome
27United States
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abstractBackground: Infection, bacteremia and sepsis are major sources of morbidity and mortality in patients with end-stage renal disease. This study sought to determine the association between predialysis chronic kidney disease (CKD) and infection-related mortality. Methods: We analyzed participants in the Third National Health and Nutrition Examination Survey (NHANES III). The study included adults ≧45- years-old without end-stage renal disease. Estimated glomerular filtration rate (eGFR) was categorized as ≧60, 45–59.9 and <45 ml/min per 1.73 m2, and urinary albumin-to-creatinine ratio (ACR) as <30, 30–299.9 and ≧300 mg/g. The study identified infection-related mortality, including septicemia, respiratory, abdominal and gastrointestinal, cardiac, kidney and genitourinary, neurologic, and other infections over a median of 13 years using the National Death Index. Results: Of 7,400 participants included in the study, 206 died from infections. Compared to individuals with eGFR ≧60 ml/min per 1.73 m2, infection-related mortality was higher for those with lower eGFR [adjusted HR = 1.36 (95% CI: 0.81, 2.30) and 2.36 (1.04, 5.38) for eGFR of 45–59.9 and <45 ml/min per 1.73 m2, respectively; p trend = 0.06]. Compared to individuals with ACR <30 mg/g, infection-related mortality was higher for ACR levels of 30–299 and ≧300 mg/g [adjusted HR = 1.68 (95% CI: 0.97, 2.92) and 2.84 (0.92, 8.74), p trend = 0.02]. Conclusions: Reduced eGFR and albuminuria are associated with increased risk for infection-related mortality. Efforts are needed to reduce its incidence and mitigate the effects of infections among individuals with CKD.
copBasel, Switzerland
pubS. Karger AG
pmid21860228
doi10.1159/000330673
tpages7
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