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Clinical impact of advanced chronic kidney disease in patients with non-HIV pulmonary cryptococcosis

発表形態:
原著論文
主要業績:
主要業績
単著・共著:
共著
発表年月:
2020年04月
DOI:
10.1186/s12890-020-1149-3
会議属性:
指定なし
査読:
有り
リンク情報:

日本語フィールド

著者:
○Hiroki Tashiro, Tetsuro Haraguchi, Koichiro Takahashi, Hironori Sadamatsu, Ryo Tajiri, Ayako Takamori, Shinya Kimura, Naoko Sueoka-Aragane
題名:
Clinical impact of advanced chronic kidney disease in patients with non-HIV pulmonary cryptococcosis
発表情報:
BMC Pulm Med 巻: 20 号: 1 ページ: 116
キーワード:
概要:
Background: Pulmonary cryptococcosis is an uncommon infectious disease that can develop in both immunocompromised and immunocompetent patients. The severity of chronic kidney disease (CKD) was reported to be one of the risk factors for pulmonary cryptococcosis, but its clinical characteristics have not been fully assessed. The purpose of this study was to clarify the clinical characteristics of advanced CKD in patients with pulmonary cryptococcosis. Methods: The present study retrospectively investigated 56 patients who had non-human immunodeficiency virus (HIV) pulmonary cryptococcosis and were treated at Saga University Hospital between 2005 and 2018. The clinical characteristics were evaluated and compared between patients with estimated glomerular filtration rate (eGFR) > 45 mL/min/1.73 m2 (n = 42, early CKD) and those with eGFR < 45 mL/min/1.73 m2 (n = 14, advanced CKD. Results: Compared with patients with early CKD, those with advanced CKD had significantly higher rate of disseminated cryptococcosis (21.4% vs. 2.4%, p = 0.03); lower percentage of patients who recovered after treatment (63.6% vs. 92.5%, p = 0.02); and more frequent clinical features of fever (57.1% vs. 19.0%, p < 0.01), pleural effusion (21.4% vs. 2.4%, p = 0.03), high white blood cell count (8550/mL vs. 6150/mL, p = 0.01) and C-reactive protein (CRP) (2.1 mg/dL vs. 0.2 mg/dL, p = 0.02), and low level of serum albumin (3.0 g/dL vs. 3.8 g/dL, p < 0.01). Multivariate analysis adjusted by immunosuppressive drug use indicated the significant factors of fever (odds ratio or β value [95% confidence interval] 6.4 [1.65-20.09], p < 0.01), high white blood cell count (1293.2 [110.2-2476.2], p = 0.03), C-reactive protein (0.89 [0.18-1.59], p = 0.01) and low level of serum albumin (- 0.34 [- 0.54 - - 0.14], p < 0.01) in patients with eGFR < 45 mL/min/1.73m2. Conclusion: Advanced CKD was associated with poor clinical characteristics and outcomes in patients with non-HIV pulmonary cryptococcosis.
抄録:

英語フィールド

Author:
○Hiroki Tashiro, Tetsuro Haraguchi, Koichiro Takahashi, Hironori Sadamatsu, Ryo Tajiri, Ayako Takamori, Shinya Kimura, Naoko Sueoka-Aragane
Title:
Clinical impact of advanced chronic kidney disease in patients with non-HIV pulmonary cryptococcosis
Announcement information:
BMC Pulm Med Vol: 20 Issue: 1 Page: 116
An abstract:
Background: Pulmonary cryptococcosis is an uncommon infectious disease that can develop in both immunocompromised and immunocompetent patients. The severity of chronic kidney disease (CKD) was reported to be one of the risk factors for pulmonary cryptococcosis, but its clinical characteristics have not been fully assessed. The purpose of this study was to clarify the clinical characteristics of advanced CKD in patients with pulmonary cryptococcosis. Methods: The present study retrospectively investigated 56 patients who had non-human immunodeficiency virus (HIV) pulmonary cryptococcosis and were treated at Saga University Hospital between 2005 and 2018. The clinical characteristics were evaluated and compared between patients with estimated glomerular filtration rate (eGFR) > 45 mL/min/1.73 m2 (n = 42, early CKD) and those with eGFR < 45 mL/min/1.73 m2 (n = 14, advanced CKD. Results: Compared with patients with early CKD, those with advanced CKD had significantly higher rate of disseminated cryptococcosis (21.4% vs. 2.4%, p = 0.03); lower percentage of patients who recovered after treatment (63.6% vs. 92.5%, p = 0.02); and more frequent clinical features of fever (57.1% vs. 19.0%, p < 0.01), pleural effusion (21.4% vs. 2.4%, p = 0.03), high white blood cell count (8550/mL vs. 6150/mL, p = 0.01) and C-reactive protein (CRP) (2.1 mg/dL vs. 0.2 mg/dL, p = 0.02), and low level of serum albumin (3.0 g/dL vs. 3.8 g/dL, p < 0.01). Multivariate analysis adjusted by immunosuppressive drug use indicated the significant factors of fever (odds ratio or β value [95% confidence interval] 6.4 [1.65-20.09], p < 0.01), high white blood cell count (1293.2 [110.2-2476.2], p = 0.03), C-reactive protein (0.89 [0.18-1.59], p = 0.01) and low level of serum albumin (- 0.34 [- 0.54 - - 0.14], p < 0.01) in patients with eGFR < 45 mL/min/1.73m2. Conclusion: Advanced CKD was associated with poor clinical characteristics and outcomes in patients with non-HIV pulmonary cryptococcosis.


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