Chronic kidney disease as a risk factor for acute community-acquired infections in high-income countries: a systematic review.
Chronic kidney disease as a risk factor for acute community-acquired infections in high-income countries: a systematic review.
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DOI：
10.1136/bmjopen-2013-004100
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发表时间：
2014-04-17
期刊：
影响因子：
2.9
通讯作者：
Nitsch D
中科院分区：
文献类型：
--
作者：
McDonald HI;Thomas SL;Nitsch D
透析前慢性肾脏疾病(CKD)与急性社区获得性感染发病率的系统回顾。我们检索了MEDLINE、EMBASE和Cochrane数据库(INSTATION至2014年1月16日)，以寻找分析透析前肾脏疾病与急性社区获得性尿路感染(UTI)、下呼吸道或中枢神经系统感染或败血症的相关性的研究。研究需要包括至少30名患有和不患有肾脏疾病的参与者。高收入国家以社区为基础的成年人人口。急性、社区获得性尿路感染、下呼吸道或中枢神经系统感染或败血症。我们确定了14项符合条件的研究。两项研究的估计缺少95%的顺应性和自愿性。其余12项研究产生了17项独立的效果评估。只有三项研究包括在社区管理的感染。质量评估显示，对肾脏疾病状态可能的错误分类和对混淆的不良调整是常见的。有一些大型高质量研究的证据表明，透析前CKD阶段和因感染住院之间存在分级关联。一项研究发现了与年龄的相互作用，随着年龄的增加，慢性肾脏病对感染风险的影响逐渐下降。有证据表明研究间的异质性(I2=96.5%，p<；0.001)在亚组分析中持续存在，因此没有进行荟萃分析。透析前肾脏疾病似乎与严重感染的风险增加有关。透析前肾脏疾病是否增加了感染的易感性，年龄是否改变了这种联系，目前尚不清楚。
A systematic review of the association of predialysis chronic kidney disease (CKD) with the incidence of acute, community-acquired infections. We searched the MEDLINE, EMBASE and Cochrane databases (inception to 16 January 2014) for studies analysing the association of predialysis kidney disease with the incidence of acute, community-acquired urinary tract infection (UTI), lower respiratory tract or central nervous system infections or sepsis. Studies were required to include at least 30 participants with and without kidney disease. Community-based populations of adults in high-income countries. Acute, community-acquired UTI, lower respiratory tract or central nervous system infections or sepsis. We identified 14 eligible studies. Estimates from two studies lacked 95% CIs and SEs. The remaining 12 studies yielded 17 independent effect estimates. Only three studies included infections managed in the community. Quality assessment revealed that probable misclassification of kidney disease status and poor adjustment for confounding were common. There was evidence from a few large high-quality studies of a graded association between predialysis CKD stage and hospitalisation for infection. One study found an interaction with age, with a declining effect of CKD on infection risk as age increased. There was evidence of between-studies heterogeneity (I2=96.5%, p<0.001) which persisted in subgroup analysis, and thus meta-analysis was not performed. Predialysis kidney disease appears to be associated with increased risk of severe infection. Whether predialysis kidney disease increases the susceptibility to infections and whether age modifies this association remains unclear.
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DOI：
10.1111/j.1532-5415.2009.02259.x
发表时间：
2009-06-01
影响因子：
6.3
作者：
Loeb, Mark;Neupane, Binod;Marrie, Thomas J.
通讯作者：
Marrie, Thomas J.
DOI：
10.1097/01.asn.0000074237.78764.d1
发表时间：
2003-07-01
影响因子：
13.6
作者：
Allon, M;Depner, TA;Schwab, SJ
通讯作者：
Schwab, SJ
影响因子：
2.9
作者：
Kausz, Annamaria T.;Gilbertson, David T.
通讯作者：
Gilbertson, David T.
影响因子：
4.4
作者：
Foley, Robert N.
通讯作者：
Foley, Robert N.
影响因子：
13.2
作者：
Collins, Allan J.;Foley, Robert N.;Agodoa, Lawrence
通讯作者：
Agodoa, Lawrence