Abstract: Ｏｂｊｅｃｔｉｖｅ：This retrospective cohort study was to evaluate the effects of cytomegaloviremia on prognosis of chronic kidney disease (CKD) patients with pneumocystis jiroveci pneumonia (PJP).
Ｍｅｔｈｏｄｏｌｏｇｙ：We analyzed the clinical features and prognosis of CKD patients with PJP who were admitted to National Clinical Research Center of Kidney Diseases, Jinling Hospital from October 2018 to January 2021. Patients were divided into PJP group and PJP+CMV group according to results of peripheral blood metagenomic secondgeneration sequencing (mNGS).
Ｒｅｓｕｌｔｓ：A total of 52 CKD patients were diagnosed with PJP, with an average age of 4606±1582 years. Among them, 30 patients were complicated with cytomegaloviremia, and the number of CMV base sequences was 355 (40,10625). CMV IgG antibody test was positive, and IgM antibody test was negative. There were no significant differences in epidemiological characteristics, CKD course, immunosuppressive types, prednisone dose and infection symptoms on the first day of admission between the two groups (P>005). The total lymphocyte count in PJP+CMV group decreased significantly during hospital stay, and the minimum CD4+T cells was lower than that in PJP group (P=0022). The number and species of other pathogenic microorganisms by mNGS in peripheral blood were more. The 30day survival rate was 6333％ in PJP+CMV group and 9091％ in PJP group (P=0025). Multivariate COX regression analysis showed that cytomegaloviremia, low oxygenation index, low CD4+T cell count and high serum G value were independent risk factors for death in CKD patients with PJP.
Ｃｏｎｃｌｕｓｉｏｎ：CKD patients complicated with PJP had a higher positive rate of cytomegaloviremia. PJP patients with cytomegaloviremia had more severe immune deficiency and worse prognosis than those without cytomegaloviremia during hospitalization.