Xu H et al. – This region-representative health care study tested the hypothesis that when estimated glomerular filtration rate (eGFR) is lower, the incidence of community-acquired infections increases and the pattern of site-specific infections varies. The study concluded that individuals with mild to severe chronic kidney disease had higher incidence of community-acquired infections. Major infections identified were lower respiratory tract infection, urinary tract infection, and sepsis.

Methods

• Correlation of eGFR with the risk of infections was estimated in health care users (N = 1,139,470 aged 52 ± 18 years, 53% women) from the Stockholm CREAtinine Measurements Project over 12 months.

Results

• There was an increase in the incidence rate of all infections with lower eGFR.
• The incidence rate increased from 74/1000 person-years for individuals with eGFR = 90 to 104 mL/min per 1.73 m2 to 419/1000 person-years for individuals with eGFR <30 mL/min per 1.73 m2.
• Compared with eGFR of 90 to 104 mL/min per 1.73 m2, the adjusted incidence rate ratios of community-acquired infections were 1.08 for eGFR of 30 to 59 mL/min per 1.73 m2 and 1.53 for eGFR <30 mL/min per 1.73 m2.
• With lower eGFR strata, the relative proportions of lower respiratory tract infection, urinary tract infection, and sepsis increased.
• For most of the infection types, the differences in incidence associated with eGFR were consistent.