Upper Respiratory Tract Infection among Dialysis Patients

作者：Cohen Hagai Keren; Rozenberg Ilan; Korzets Ze'ev; Zitman Gal Tali; Einbinder Yael; Benchetrit Sydney^*

来源：Israel Medical Association Journal, 2016, 18(9): 557-560.

• dialysis
• upper respiratory tract infection (URTI)
• influenza
• viral infection
• influenza vaccination

Background: Upper respiratory tract infection (URTI) occurs frequently in the general population and is considered a benign self-limited disease. Dialysis patients constitute a high risk population whose morbidity and mortality rate as a result of URTI is unknown.
Objectives: To assess the local incidence, morbidity and mortality of URTI in dialysis patients compared to the general population.
Methods: In this retrospective cohort study we reviewed the charts of all chronic dialysis patients diagnosed with URTI at Meir Medical Center, Kfar Saba, Israel during the 2014-2015 winter season.
Results: Among 185 dialysis patients, 40 were found to be eligible for the study. The average age was 66.1 +/- 15.7 years, and the co-morbidity index was high. Influenza A was the most common pathogen found, followed by rhinovirus, respiratory syncytial virus and para-influenza. Of the 40 patients 21 (52.5%) developed complications: pneumonia in 20%, hospitalization in 47.5%, and respiratory failure requiring mechanical ventilation in 12.5%. Overall mortality was 10%. General population data during the same seasonal period showed a peak pneumonia incidence of 4.4% compared to 20% in the study population (P < 0.0001).
Conclusions: The study findings show that compared to the general population, in dialysis patients URTI is a much more severe disease and has a higher complication rate. Influenza A, the most common pathogen, is associated with a worse prognosis.

• 出版日期2016-9