Clinical Characteristics of Pneumonia Occurred in Hemodialysis Patients

Kim, Young Soo; Kim, Yong Hwan; Song, Sun Wha; Yoon, Sun Ae; Jung, Byoung Ha; Kim, Gil Sun; Kim, Yong Soo; Kim, Young Ok

Abstract

PURPOSE: The most common infectious diseases in hemodialysis (HD) patients are sepsis and pneumonia. Although there are many data about sepsis in HD patients, pneumonia in HD patients is rarely reported. This study was conducted to compare clinical severity of pneumonia between HD patients and healthy persons.
METHODS
This study enrolled 36 HD patients who were admitted for pneumonia. Age- and sex-matched 37 persons with pneumonia who did not have any other medical illness were included as a control. We compared clinical manifestations, laboratory and radiologic findings, complications, and clinical course between HD patients and controls.
RESULTS
The positive rates of blood and sputum bacterial culture in the HD patients were higher than in those in the controls (blood; 17.6% vs. 2.7%, p=0.028, sputum; 30.3% vs. 5.4%, p=0.005). Compared to the controls, the HD patients had higher incidence of thrombocytopenia (25.0% vs. 0%, p=0.001) and hypoxia (41.7% vs. 2.7%, p=0.000). The number of the lobes involved was larger and higher incidence of bilateral lesions and parapneumonic effusions were observed in the HD patients. In addition, the HD patients had higher incidence of recurrence than the controls (16.7% vs. 0%, p=0.025). Pneumonia-related mortality rate tended to be higher in the HD patients than the controls but there was no statistical differences between the two groups (11.1% vs. 0%, p=0.054).
CONCLUSION
This study shows that pneumonia in HD patients takes a more severe clinical course than in healthy persons. It seems that pneumonia in HD patients has a higher propensity to develop bacteremia.