title: The risk of infection-related hospitalization with decreased kidney function.
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.
  
  
  METHODS
  Cohort study.
  
  
  METHODS
  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.
  
  
  METHODS
  The primary exposure of interest was eGFR using serum cystatin C level (eGFR(SCysC)).
  
  
  RESULTS
  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).
  
  
  CONCLUSIONS
  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.
authors: Department of Medicine, University of California Davis, USA. lorien.dalrymple@ucdmc.ucdavis.edu
authors: Lorien S
authors: LS
authors: Dalrymple
authors: Ronit
authors: R
authors: Katz
authors: Bryan
authors: B
authors: Kestenbaum
authors: Ian H
authors: IH
authors: de Boer
authors: Linda
authors: L
authors: Fried
authors: Mark J
authors: MJ
authors: Sarnak
authors: Michael G
authors: MG
authors: Shlipak
mesh_terms: D000368:Aged; D015331:Cohort Studies; D005260:Female; D005919:Glomerular Filtration Rate; D006760:Hospitalization; D006801:Humans; D007239:Infections / Q000453:epidemiology* / Q000209:etiology*; D007668:Kidney / Q000503:physiopathology*; D008297:Male; D012307:Risk Factors