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Urinary tract infection in patients with chronic kidney disease
Chih-yen Hsiao1, Hsing-lin Lin, Yen-ko Lin
1Department of Internal Medicine, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Taiwan.
Insights
Urinary tract infections (UTIs) in chronic kidney disease (CKD) patients are common in the elderly. Female sex and renal stones are linked to upper UTIs in these patients.
Area of Science:
- Nephrology
- Infectious Diseases
- Epidemiology
Background:
- Chronic kidney disease (CKD) presents a significant global healthcare challenge.
- Limited data exists on the epidemiology, clinical features, and outcomes of urinary tract infections (UTIs) in CKD patients.
Purpose of the Study:
- To retrospectively analyze epidemiological and clinical data of UTIs in hospitalized CKD patients.
- To identify factors associated with upper UTIs in this population.
Main Methods:
- Retrospective cohort study from 2005-2011.
- Comparison of demographic and clinical data between upper and lower UTI patients.
- Logistic regression analysis to determine predictors of upper UTI.
Main Results:
- 276 bacteriuria patients with upper and lower UTIs were analyzed.
- Older age, female sex, and presence of renal stones were independently associated with upper UTI.
- Average age for upper UTI patients was 59.21 years, and for lower UTI patients was 71.18 years.
Conclusions:
- CKD patients with UTIs are often elderly.
- Females and patients with renal stones have a higher risk of bacteriuria and upper UTIs.
- Aggressive management of renal stones is recommended for CKD patients to prevent upper UTIs.
Aim:
Chronic kidney disease (CKD) has become a burden of health care globally. However, data on epidemiology, clinical features, and outcomes of urinary tract infection (UTI) in this population are scarce. This study aims to retrospectively review such data.
Materials And Methods:
A retrospective cohort study was conducted from 1 January 2005 to 31 December 2011 in patients with CKD requiring hospitalization. Patients who had upper and lower UTIs were compared for demography and clinical data. Logistic regressior was used to assess which variables were associated with upper UTI.
Results:
A total of 276 bacteriuria patients were admitted to our ward with upper and lower UTIs. The average ages of the upper and lower UTI patients were 59.21 +/- 16.54 and 71.18 +/- 14.77 years, respectively. The results of logistic regression analysis showed that age (OR 0.946, P < 0.001), female sex (OR 4.695, P < 0.001), and renal stones (OR 8.232, P < 0.001) were independently associated with upper UTI.
Conclusion:
This study shows that patients with CKD and UTIs were elderly, and that females were prone to have more bacteriuria and upper UTIs than males. In addition, patients who had renal stones were more prone to have upper UTI than other bacteriuria patients Aggressive treatment of renal stones should be considered in these patients.
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