Dangerous Infections Increase as Kidney Function Falters

(NEW YORK, NY)—March 1, 2012 — Individuals with even moderately-reduced kidney function are more likely to be hospitalized due to infection, according to a new report published in the March issue of the American Journal of Kidney Diseases, the official journal of the National Kidney Foundation.

The study focused on seniors, over the age of 65, who had reduced kidney function, but not renal failure. Individuals with renal failure often have high rates of infections that result in hospitalization or death.

However, researchers said it was surprising that an increased risk of infection-related hospitalization was also found in individuals with early stages of chronic kidney disease.

“In the U.S., approximately 1 in 3 adults aged 65 and older has chronic kidney disease. Serious infection is an underappreciated complication of chronic kidney disease,” said Dr. Lorien S. Dalrymple, lead author of the study. “Even mild to moderately reduced kidney function is associated with a clinically meaningful increase in the risk of infection-related hospitalization.”

Those who had reduced kidney function were found to have up to 64 percent greater risk for all-cause infection-related hospitalization. Those with stage 3b or 4 chronic kidney disease (stage 1 being mild, stage 5 being renal failure), were found to be 80 percent more at risk for pulmonary infections like pneumonia, and 160 percent more at risk for infections in the urinary system when compared with participants with normal renal function. The findings were extrapolated from the Cardiovascular Health Study, and included more than 5,100 participants.

The report, investigated by Dr. Dalrymple and others, is further proof that chronic kidney disease is associated with a number of serious complications, including infection. Chronic kidney disease is a silent killer that affects more than 26 million Americans. Most people don’t know they have the disease until it is too late.

The study findings also underscore the need for vaccines for those with chronic kidney disease, to help keep infections at bay.

“This study clearly shows that people with chronic kidney disease need to take at least two vaccines to help prevent infection and infectious hospitalization,” said Dr. Joseph Vassalotti Chief Medical Officer of the National Kidney Foundation. “The key vaccines are an annual flu shot, and the pneumococcal vaccine, the latter of which should be given once with a re-vaccination within 5 years.”

The study also has an important takeaway for healthcare providers, as the cystatin C-based estimates of kidney function were used in this study, but the association between kidney function and infection could not be detected by serum creatinine-based measures until kidney function was moderately to severely reduced,

“Our findings highlight the important differences between cystatin C- and serum creatinine-based estimates of kidney function and provide further evidence that the risks associated with CKD in the elderly are not adequately detected and measured by creatinine,” said Dr. Dalrymple. “We hope that our findings increase the awareness of the risk of serious infection in CKD and stimulate further research in this area.”

The National Kidney Foundation is dedicated to preventing kidney and urinary tract diseases, improving the health and well-being of individuals and families affected by these diseases and increasing the availability of all organs for transplantation. For more information, visit www.kidney.org.