Clinical Characteristics of Pneumonia Occurred in Hemodialysis Patients

Korean Journal of Nephrology 2007;26(5):575-581.

Young Soo Kim, M.D.1, Yong Hwan Kim, M.D.2 , Sun Wha Song, M.D.3 Sun Ae Yoon, M.D.1, Byoung Ha Jung, M.D.1 , Gil Sun Kim, M.D.1 Yong Soo Kim, M.D.1 and Young Ok Kim, M.D.

Department of Internal Medicine¹
Thoracic Surgery²
Radiology3 , College of Medicine The Catholic University of Korea, Seoul, Korea

혈액투석 환자에서 발생한 폐렴의 임상적 특성에 관한 연구

김영수1 김용환2 송선화3 윤선애1 정병하1 김길선1 김용수1 김영옥1

가톨릭대학교 의과대학 내과학교실1, 흉부외과학교실2, 방사선과학교실3

Abstract

Purpose : The most common infectious diseases in hemodialysis (HD) patients are sepsis and pneumonia. Although there are many data about sepsis in HD patients, pneumonia in HD patients is rarely reported. This study was conducted to compare clinical severity of pneumonia between HD patients and healthy persons. Methods : This study enrolled 36 HD patients who were admitted for pneumonia. Age- and sex-matched 37 persons with pneumonia who did not have any other medical illness were included as a control. We compared clinical manifestations, laboratory and radiologic findings, complications, and clinical course between HD patients and controls. Results : The positive rates of blood and sputum bacterial culture in the HD patients were higher than in those in the controls (blood; 17.6% vs. 2.7%, p=0.028, sputum; 30.3% vs. 5.4%, p=0.005). Compared to the controls, the HD patients had higher incidence of thrombocytopenia (25.0% vs. 0%, p=0.001) and hypoxia (41.7% vs. 2.7%, p=0.000). The number of the lobes involved was larger and higher incidence of bilateral lesions and parapneumonic effusions were observed in the HD patients. In addition, the HD patients had higher incidence of recurrence than the controls (16.7% vs. 0%, p=0.025). Pneumonia-related mortality rate tended to be higher in the HD patients than the controls but there was no statistical differences between the two groups (11.1% vs. 0%, p=0.054). Conclusion : This study shows that pneumonia in HD patients takes a more severe clinical course than in healthy persons. It seems that pneumonia in HD patients has a higher propensity to develop bacteremia.

Key Words: Pneumonia, Hemodialysis, Bacteremia