Clostridioides difficile Infection in Chronic Kidney Disease—An Overview for Clinicians

Abstract

Increased incidence of Clostridioides difficile infection (CDI), occurrence of severe and complicated CDI, and more frequent occurrence of drug-resistant, recurrent or non-hospital CDI has become a worldwide clinical problem. CDI is more common in patients with chronic kidney disease (CKD) than in the general population. CDI seems to be associated with frequent hospitalization, frequently used antibiotic therapy, dysbiosis, and abnormalities of the immune system observed in CKD patients. Dysbiosis is a common disorder found in CKD patients. It may be related to insufficient fiber content in the diet, reduced amount of consumed fluids and often reduced physical activity, constipation, impaired gastrointestinal motility, multidrug pharmacotherapy, and uremic milieu in CKD stage 5. In patients with CKD the clinical manifestations of CDI are similar to the general population; however, more frequent recurrence of CDI and higher prevalence of severe CDI are reported. Moreover, the increase in CDI related mortality is observed more in CKD patients than in the general population. The aim of this review paper is to summarize the current knowledge concerning the epidemiology, pathogenesis, clinical picture, and prevention and treatment in CKD patients.

A Systematic Literature Review on Risk Factors for and Timing of Clostridioides difficile Infection in the United States

“…Kidney disease was a risk factor for primary CDI and rCDI, as has been previously reported [146]. Patients with chronic kidney disease are often old, with greater exposure to the healthcare system than the general population, and they typically have immune deficiencies with a reliance on antibiotics to fight infections, all of which contribute to an increased risk of CDI [146,147]. Hypoalbuminemia and high serum creatinine levels are also associated with kidney disease and are further risk factors for CDI.…”

The Role of Probiotics in the Prevention of Clostridioides difficile Infection in Patients with Chronic Kidney Disease

“…Three review articles (two of them were published by Dudzicz et al from our group) concerning CDI prophylaxis with Lactobacillus plantarum 299v (LP299v) in hospitalised patients in the nephrology and transplantation ward were published [ 38 , 39 , 40 ]. The results discussed in these review articles were related to a retrospective analysis of the cohort consisting of 5341 hospitalized patients during three consecutive one-year periods published by Dudzicz et al [ 41 ].…”

Unveiling the threat: Characterization ofClostridioides difficileInfection in the Northwest Region of Buenos Aires between 2019-2023 and Associated Risk Factors redefined through a Meta-Analysis

“…Finally, several underlying health conditions that could compromise the immune system could contribute to increased susceptibility or severity of the infection. Comorbidities such as Inflammatory Bowel Disease (IBD) 25 , Crohn’s disease 25 , ulcerative colitis 25 , diabetes 26 and chronic kidney disease (CKD) 27 can enhance the risk of CDI.…”

“…Comorbidities such as Inflammatory Bowel Disease (IBD) 25 , Crohn's disease 25 , ulcerative colitis 25 , diabetes 26 and chronic kidney disease (CKD) 27 can enhance the risk of CDI.…”