ISSN 1006-298X      CN 32-1425/R

Chinese Journal of Nephrology, Dialysis & Transplantation ›› 2022, Vol. 31 ›› Issue (4): 310-316.DOI: 10.3969/j.issn.1006298X.2022.04.003

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Pneumocystis jiroveci pneumonia in acquired immune deficiency syndrome and chronic kidney disease patients

  

  • Online:2022-08-29 Published:2022-08-26

Abstract: Objective:This retrospective study was to evaluate the clinical characteristics and prognosis of pneumocystis jiroveci pneumonia (PJP) in acquired immune deficiency syndrome (AIDS) and chronic kidney disease (CKD) patients.
Methodology:We retrospectively analyzed the clinical features and prognosis of PJP in AIDS and immunosuppressed CKD patients who were admitted to Department of Infectious Disease, the Second Hospital of Nanjing and National Clinical Research Center of Kidney Diseases, Jinling Hospital from October 2018 to April 2022.
Results:A total of 79 PJP patients with CKD and 31 patients with AIDS were enrolled in this study. Compared with AIDS group, the time from PJP symptoms to diagnosis was shorter in CKD group. Patients in CKD group had lower oxygenation index, total lymphocyte count, albumin, globulin, CD3+T, CD8+T and higher total neutrophil count, lactate dehydrogenase, CD4+T, Creactive protein, procalcitonin, interleukin6, serum (1,3) βDGlucan at admission. The number of pneumocystis jiroveci (PJ) base sequence in bronchoalveolar lavage fluid in CKD group was less, but the bacterial species were more than that in AIDS group. CT showed that the proportion of ground glass lesions in CKD group was lower, and the proportion of patchy shadows was higher than that in AIDS group. The 90day survival rates of CKD group and AIDS group were 6962% and 9355%(P=001), respectively.
Conclusion:Compared with AIDS patients, CKD patients with PJP had lower PJ load, but had severe inflammatory response, more pulmonary mixed infection, rapid disease progression and worse prognosis.


Key words: chronic kidney disease,acquired immune deficiency syndrome,pneumocystis jiroveci pneumonia