埼玉医科大学雑誌 第40巻 第2号 (2014年3月) 123-130頁 ◇論文(図表を含む全文)は，PDFファイルとなっています．
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慢性腎臓病（chronic kidney disease: CKD）患者における細菌感染症入院に関わるリスクの検討
佐藤 貴彦＊，井上 勉，鈴木 洋通
埼玉医科大学 医学部 腎臓内科
〔平成25年11月13日 受付 / 平成26年2月4日 受理〕
Risk factors for bacterial infection-related hospitalization in chronic kidney disease (CKD) patients
Takahiko Sato＊, Tsutomu Inoue, and Hiromichi Suzuki
Department of Nephrology, Faculty of Medicine, Saitama Medical University,
38 Morohongo, Moroyama, Iruma-gun, Saitama, 350-0495, Japan
To date, it is unknown whether renal insufficiency is associated with increased morbidity from bacterial infections. The aim of this study is to evaluate the relationship between renal insufficiency and bacterial infection-related hospitalization.
This study is an observational, retrospective cohort study at our center. Nominal logistic regression analysis was used for multivariate analysis. The event investigated was “bacterial infection making hospitalization necessary”, and the investigation items were gender, age, diabetes mellitus, presence of cancer, use of statins and immunosuppressive agents, and several laboratory values, including albumin levels and total cholesterol.
All patients visiting our outpatient clinic between January and December 2005, and for whom complete medical records were available for at least 3 years from 2005, were enrolled. Patients who received renal replacement therapy, peritoneal dialysis (PD), or hemodialysis (HD), were excluded.
A total of 836 patients were surveyed (466 males; 370 females). The mean period of observation was 4.87±1.39 years. A total of 61 patients had at least one episode of hospitalization and were categorized as the “infected group”. The mean estimated glomerular filtration rate (eGFR) was 56.3±36.8 ml/min/1.73 m2 in the infected group and 64.3±35.4 ml/min/1.73 m2 in the non-infected group. The percentages of chronic kidney disease (CKD) stage 3 or more were 63.9% in the infected group and 45.1% in the non-infected group, with more patients with advanced renal insufficiency observed in the infected group than in the non-infected group. In a multivariate logistic regression analysis, a CKD stage of 3 or more, immunosuppressive agents, and diabetes mellitus were statistically significant risk factors for bacterial infection-related hospitalization; the adjusted odds ratio were 2.177, 2.443, and 2.140 respectively.
Renal insufficiency, immunosuppressive agents, and diabetes mellitus are important risk factors for bacterial infection-related hospitalization.
J Saitama Medical University 2014; 40(2): 123-130
(Received November 13, 2013 / Accepted February 4, 2014)
Keywords: chronic kidney disease, bacterial infection, risk factor, diabetes mellitus
(C) 2014 The Medical Society of Saitama Medical University