Abstract
Background: 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. Study Design: Cohort study. Setting & Participants: 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. Predictor: The primary exposure of interest was eGFR using serum cystatin C level (eGFR SCysC). Outcome: Infection-related hospitalizations during a median follow-up of 11.5 years. Results: 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. Limitations: No measures of urinary protein, study limited to principal discharge diagnosis. Conclusions: 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.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 356-363 |
| Number of pages | 8 |
| Journal | American Journal of Kidney Diseases |
| Volume | 59 |
| Issue number | 3 |
| DOIs | |
| State | Published - Mar 2012 |
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Keywords
- chronic kidney disease
- clinical epidemiology
- infection
- Renal disease
ASJC Scopus subject areas
- Nephrology
Cite this
The risk of infection-related hospitalization with decreased kidney function. / Dalrymple, Lorien; Katz, Ronit; Kestenbaum, Bryan; De Boer, Ian H.; Fried, Linda; Sarnak, Mark J.; Shlipak, Michael G.
In: American Journal of Kidney Diseases, Vol. 59, No. 3, 03.2012, p. 356-363.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - The risk of infection-related hospitalization with decreased kidney function
AU - Dalrymple, Lorien
AU - Katz, Ronit
AU - Kestenbaum, Bryan
AU - De Boer, Ian H.
AU - Fried, Linda
AU - Sarnak, Mark J.
AU - Shlipak, Michael G.
PY - 2012/3
Y1 - 2012/3
N2 - Background: 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. Study Design: Cohort study. Setting & Participants: 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. Predictor: The primary exposure of interest was eGFR using serum cystatin C level (eGFR SCysC). Outcome: Infection-related hospitalizations during a median follow-up of 11.5 years. Results: 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. Limitations: No measures of urinary protein, study limited to principal discharge diagnosis. Conclusions: 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.
AB - Background: 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. Study Design: Cohort study. Setting & Participants: 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. Predictor: The primary exposure of interest was eGFR using serum cystatin C level (eGFR SCysC). Outcome: Infection-related hospitalizations during a median follow-up of 11.5 years. Results: 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. Limitations: No measures of urinary protein, study limited to principal discharge diagnosis. Conclusions: 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.
KW - chronic kidney disease
KW - clinical epidemiology
KW - infection
KW - Renal disease
UR - http://www.scopus.com/inward/record.url?scp=84857350320&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84857350320&partnerID=8YFLogxK
U2 - 10.1053/j.ajkd.2011.07.012
DO - 10.1053/j.ajkd.2011.07.012
M3 - Article
C2 - 21906862
AN - SCOPUS:84857350320
VL - 59
SP - 356
EP - 363
JO - American Journal of Kidney Diseases
JF - American Journal of Kidney Diseases
SN - 0272-6386
IS - 3
ER -