Pneumonia in Patients with Chronic Kidney Disease Admitted to Nephrology Department of a Tertiary Care Center: A Descriptive Cross-sectional Study

Abstract

Introduction: Chronic Kidney Disease is an independent risk factor for pneumonia. The risk of hospitalization, Intensive Care Unit and ventilator requirement, in-hospital death is high in pneumonia patients with chronic kidney disease. This study aims to find the prevalence of pneumonia in patients with chronic kidney disease admitted to nephrology department of a tertiary care center. Methods: A descriptive cross-sectional study was conducted among all the hospital records of pneumonia patients with Chronic Kidney Disease admitted to the Nephrology department between April 2019 and April 2021. Ethical clearance was obtained from the Institutional Review Committee of same institute (Reference number: 0505202106). Statistical Package for the Social Sciences version 20 was used for analysis. Point estimate at 95% Confidence Interval was calculated along with frequency and proportion for binary data. Results: Of the total 407 patients with Chronic Kidney Disease, 78 (19.1%) (95% Confidence Interval= 15.28-22.92) had pneumonia. Among the 78 pneumonia patients, 17 (21.8%) were Stage 3, 13 (16.7%) Stage 4 and 48 (61.5%) Stage 5 of chronic kidney disease. Forty Seven (60.3%) required Intensive Care Unit (ICU), 19 (24.4%) required ventilator and 22 (28.2%) of the patient expired in hospital. The most commonly isolated organisms were Severe Acute Respiratory Syndrome Coronavirus 2 which was 13 (16.6%) followed by Strepotococcus pneumoniae which was 8 (10.2%). Conclusions: The prevalence of pneumonia in Chronic Kidney Disease was observed higher in our study compared to other studies.

Relationship between Acute Respiratory Tract Infection and the Serum 25(OH) D3 Level in Chronic Kidney Disease Patients and Its Prevention and Treatment

“…Regarding the molecular structure, 25-OH-D3 is the addition of a hydroxyl group to the 25-position carbon atom of vitamin D3 [ 22 – 24 ]. However, this addition occurs in the body through a series of biochemical reactions, through the 25-hydroxylase hydroxylation in the mitochondria of liver cells, which then forms 25-hydroxyvitamin D3 [ 25 ].…”

“…The exclusion criteria were as follows: patients with other systemic diseases or serious infectious diseases, patients with incomplete clinical data and information, patients who had recently taken glucocorticoids and other drugs for treatment, and patients undergoing hemodialysis or kidney transplantation were excluded from the study. Regarding the molecular structure, 25-OH-D3 is the addition of a hydroxyl group to the 25-position carbon atom of vitamin D3 [22][23][24]. However, this addition occurs in the body through a series of biochemical reactions, through the 25-hydroxylase hydroxylation in the mitochondria of liver cells, which then forms 25-hydroxyvitamin D3 [25].…”