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Hospital admissions for severe infections in people with chronic kidney disease in relation to renal disease severity and diabetes status.

Ellen BerniNicholas PritchardSara Jenkins-JonesPhilip AmberyMeena JainLutz JermutusLaura A ScottCraig J Currie
Published in: Endocrinology, diabetes & metabolism (2018)
eGFR and degree of albuminuria were independent markers of hospitalized infection in both patients with and without diabetes. The same patterns of hazard ratios of eGFR and proteinuria were seen in CKD patients regardless of diabetes status, with the risk of each outcome increasing with a decreasing eGFR and increasing proteinuria. Infection risk increased significantly from eGFR stage G3b and proteinuria stage A2 in type 2 diabetes. Treating type 2 DM patients with CKD at eGFR stages G1-G3a with immunosuppressive therapy may therefore provide a favourable risk-benefit ratio (G1-G3a in type 2 diabetes; G1-G2 in nondiabetes and overall cohorts) although the degree of proteinuria needs to be considered.
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