Clinical impact of advanced chronic kidney disease in patients with non-HIV pulmonary cryptococcosis
Abstract Background Pulmonary cryptococcosis is an uncommon infectious disease that can develop in both immunocompromised and immunocompetent patients. The severity of chronic kidney disease (CKD) was reported to be one of the risk factors for pulmonary cryptococcosis, but its clinical characteristi...
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doaj-499c6cf2cccc4ce8ab44272deb3353852020-11-25T03:14:00ZengBMCBMC Pulmonary Medicine1471-24662020-04-012011610.1186/s12890-020-1149-3Clinical impact of advanced chronic kidney disease in patients with non-HIV pulmonary cryptococcosisHiroki Tashiro0Tetsuro Haraguchi1Koichiro Takahashi2Hironori Sadamatsu3Ryo Tajiri4Ayako Takamori5Shinya Kimura6Naoko Sueoka-Aragane7Division of Hematology, Respiratory Medicine and Oncology, Department of Internal Medicine, Faculty of Medicine, Saga UniversityDivision of Hematology, Respiratory Medicine and Oncology, Department of Internal Medicine, Faculty of Medicine, Saga UniversityDivision of Hematology, Respiratory Medicine and Oncology, Department of Internal Medicine, Faculty of Medicine, Saga UniversityDivision of Hematology, Respiratory Medicine and Oncology, Department of Internal Medicine, Faculty of Medicine, Saga UniversityClinical Research Center, Saga University HospitalClinical Research Center, Saga University HospitalDivision of Hematology, Respiratory Medicine and Oncology, Department of Internal Medicine, Faculty of Medicine, Saga UniversityDivision of Hematology, Respiratory Medicine and Oncology, Department of Internal Medicine, Faculty of Medicine, Saga UniversityAbstract Background Pulmonary cryptococcosis is an uncommon infectious disease that can develop in both immunocompromised and immunocompetent patients. The severity of chronic kidney disease (CKD) was reported to be one of the risk factors for pulmonary cryptococcosis, but its clinical characteristics have not been fully assessed. The purpose of this study was to clarify the clinical characteristics of advanced CKD in patients with pulmonary cryptococcosis. Methods The present study retrospectively investigated 56 patients who had non-human immunodeficiency virus (HIV) pulmonary cryptococcosis and were treated at Saga University Hospital between 2005 and 2018. The clinical characteristics were evaluated and compared between patients with estimated glomerular filtration rate (eGFR) > 45 mL/min/1.73 m2 (n = 42, early CKD) and those with eGFR < 45 mL/min/1.73 m2 (n = 14, advanced CKD. Results Compared with patients with early CKD, those with advanced CKD had significantly higher rate of disseminated cryptococcosis (21.4% vs. 2.4%, p = 0.03); lower percentage of patients who recovered after treatment (63.6% vs. 92.5%, p = 0.02); and more frequent clinical features of fever (57.1% vs. 19.0%, p < 0.01), pleural effusion (21.4% vs. 2.4%, p = 0.03), high white blood cell count (8550/mL vs. 6150/mL, p = 0.01) and C-reactive protein (CRP) (2.1 mg/dL vs. 0.2 mg/dL, p = 0.02), and low level of serum albumin (3.0 g/dL vs. 3.8 g/dL, p < 0.01). Multivariate analysis adjusted by immunosuppressive drug use indicated the significant factors of fever (odds ratio or β value [95% confidence interval] 6.4 [1.65–20.09], p < 0.01), high white blood cell count (1293.2 [110.2–2476.2], p = 0.03), C-reactive protein (0.89 [0.18–1.59], p = 0.01) and low level of serum albumin (− 0.34 [− 0.54 – − 0.14], p < 0.01) in patients with eGFR < 45 mL/min/1.73m2. Conclusion Advanced CKD was associated with poor clinical characteristics and outcomes in patients with non-HIV pulmonary cryptococcosis. Trial registration The patients in this study were registered retrospectively.http://link.springer.com/article/10.1186/s12890-020-1149-3Pulmonary cryptococcosisChronic kidney diseaseClinical manifestationsDissemination |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Hiroki Tashiro Tetsuro Haraguchi Koichiro Takahashi Hironori Sadamatsu Ryo Tajiri Ayako Takamori Shinya Kimura Naoko Sueoka-Aragane |
spellingShingle |
Hiroki Tashiro Tetsuro Haraguchi Koichiro Takahashi Hironori Sadamatsu Ryo Tajiri Ayako Takamori Shinya Kimura Naoko Sueoka-Aragane Clinical impact of advanced chronic kidney disease in patients with non-HIV pulmonary cryptococcosis BMC Pulmonary Medicine Pulmonary cryptococcosis Chronic kidney disease Clinical manifestations Dissemination |
author_facet |
Hiroki Tashiro Tetsuro Haraguchi Koichiro Takahashi Hironori Sadamatsu Ryo Tajiri Ayako Takamori Shinya Kimura Naoko Sueoka-Aragane |
author_sort |
Hiroki Tashiro |
title |
Clinical impact of advanced chronic kidney disease in patients with non-HIV pulmonary cryptococcosis |
title_short |
Clinical impact of advanced chronic kidney disease in patients with non-HIV pulmonary cryptococcosis |
title_full |
Clinical impact of advanced chronic kidney disease in patients with non-HIV pulmonary cryptococcosis |
title_fullStr |
Clinical impact of advanced chronic kidney disease in patients with non-HIV pulmonary cryptococcosis |
title_full_unstemmed |
Clinical impact of advanced chronic kidney disease in patients with non-HIV pulmonary cryptococcosis |
title_sort |
clinical impact of advanced chronic kidney disease in patients with non-hiv pulmonary cryptococcosis |
publisher |
BMC |
series |
BMC Pulmonary Medicine |
issn |
1471-2466 |
publishDate |
2020-04-01 |
description |
Abstract Background Pulmonary cryptococcosis is an uncommon infectious disease that can develop in both immunocompromised and immunocompetent patients. The severity of chronic kidney disease (CKD) was reported to be one of the risk factors for pulmonary cryptococcosis, but its clinical characteristics have not been fully assessed. The purpose of this study was to clarify the clinical characteristics of advanced CKD in patients with pulmonary cryptococcosis. Methods The present study retrospectively investigated 56 patients who had non-human immunodeficiency virus (HIV) pulmonary cryptococcosis and were treated at Saga University Hospital between 2005 and 2018. The clinical characteristics were evaluated and compared between patients with estimated glomerular filtration rate (eGFR) > 45 mL/min/1.73 m2 (n = 42, early CKD) and those with eGFR < 45 mL/min/1.73 m2 (n = 14, advanced CKD. Results Compared with patients with early CKD, those with advanced CKD had significantly higher rate of disseminated cryptococcosis (21.4% vs. 2.4%, p = 0.03); lower percentage of patients who recovered after treatment (63.6% vs. 92.5%, p = 0.02); and more frequent clinical features of fever (57.1% vs. 19.0%, p < 0.01), pleural effusion (21.4% vs. 2.4%, p = 0.03), high white blood cell count (8550/mL vs. 6150/mL, p = 0.01) and C-reactive protein (CRP) (2.1 mg/dL vs. 0.2 mg/dL, p = 0.02), and low level of serum albumin (3.0 g/dL vs. 3.8 g/dL, p < 0.01). Multivariate analysis adjusted by immunosuppressive drug use indicated the significant factors of fever (odds ratio or β value [95% confidence interval] 6.4 [1.65–20.09], p < 0.01), high white blood cell count (1293.2 [110.2–2476.2], p = 0.03), C-reactive protein (0.89 [0.18–1.59], p = 0.01) and low level of serum albumin (− 0.34 [− 0.54 – − 0.14], p < 0.01) in patients with eGFR < 45 mL/min/1.73m2. Conclusion Advanced CKD was associated with poor clinical characteristics and outcomes in patients with non-HIV pulmonary cryptococcosis. Trial registration The patients in this study were registered retrospectively. |
topic |
Pulmonary cryptococcosis Chronic kidney disease Clinical manifestations Dissemination |
url |
http://link.springer.com/article/10.1186/s12890-020-1149-3 |
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