Pneumococcal pneumonia infection is associated with end-stage renal disease in adult hospitalized patients.
Pneumococcal disease leads to renal complications ranging from persistent proteinuria to end-stage renal disease (ESRD) in pediatric patients. However, long-term renal effects after pneumococcal pneumonia infection in adult patients remains largely unknown. To evaluate this we conducted a population-based retrospective cohort study consisting of 18,733 adult patients at the time of pneumococcal pneumonia diagnosis, using claims data from Taiwan's National Health Insurance Research Database (NHIRD) with a comparison cohort of 73,409 age- and gender-matched patients without pneumococcal pneumonia. The overall incidence rate ratio of ESRD was 23% higher in those with pneumococcal pneumonia than in those without pneumococcal pneumonia (5.26 vs. 3.10 per 1000 person-years), with an adjusted hazard ratio of 1.14 (95% confidence interval 1.01-1.29). In addition, the risk of developing ESRD was associated with covariates including age, gender, chronic kidney disease, diabetes mellitus, hypertension, hyperlipidemia, chronic obstructive pulmonary disease, and heart failure. The ESRD cumulative incidence curve showed a considerably higher risk of ESRD in those with pneumococcal pneumonia than in those without pneumococcal pneumonia (significant by log-rank test). Thus, pneumococcal pneumonia may be associated with an increased risk of ESRD in adult patients. A long-term follow-up of renal function is recommended for adult hospitalized patients with pneumococcal pneumonia infection.
1] Division of Nephrology, Department of Medicine, Taichung Veterans General Hospital, Taichung, Taiwan [2] Graduate Institute of Clinical Medicine Science, School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan.
Shih-Ting
ST
Huang
Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan.
Cheng-Li
CL
Lin
Department of Health Promotion and Health Education, National Taiwan Normal University, Taipei, Taiwan.
Yen-Jung
YJ
Chang
Graduate Institute of Cancer Biology and Center for Molecular Medicine, China Medical University, Taichung, Taiwan.
Yuh-Pyng
YP
Sher
Division of Nephrology, Department of Medicine, Taichung Veterans General Hospital, Taichung, Taiwan.
Ming-Ju
MJ
Wu
Division of Nephrology, Department of Medicine, Taichung Veterans General Hospital, Taichung, Taiwan.
Kuo-Hsiung
KH
Shu
1] Graduate Institute of Clinical Medicine Science, School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan [2] Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan.
Fung-Chang
FC
Sung
1] Graduate Institute of Clinical Medicine Science, School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan [2] School of Medicine, China Medical University, Taichung, Taiwan [3] Department of Nuclear Medicine and PET Center, China Medical University Hospital, Taichung, Taiwan.
Chia-Hung
CH
Kao
D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D015897:Comorbidity; D016208:Databases, Factual; D005260:Female; D006760:Hospitalization; D006801:Humans; D015994:Incidence; D007676:Kidney Failure, Chronic / Q000175:diagnosis / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D011018:Pneumonia, Pneumococcal / Q000175:diagnosis / Q000453:epidemiology* / Q000382:microbiology; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D012737:Sex Factors; D013624:Taiwan / Q000453:epidemiology; D013997:Time Factors; D055815:Young Adult