Background: Infection is the second-leading cause of
death among patients with end-stage renal disease (ESRD). This is due
in part to advanced age, comorbid conditions, and immune dysfunction
observed in uremic states. Although one may hypothesize that pulmonary
infectious mortality is higher among patients with ESRD compared with
the general population (GP), no such data are currently available.
Methods: We compared annual pulmonary infectious mortality
rates among patients with ESRD to those in the GP. The data were
abstracted from the United States Renal Data System and the National
Center for Health Statistics, respectively, and were stratified by age,
gender, race, and presence or absence of diabetes mellitus (DM). In the
GP, primary and multiple cause-of-death analyses were performed to
account for potential limitations of the data sources.
Results: Overall, pulmonary infectious mortality rate was
14-fold to 16-fold higher in dialysis patients and approximately
twofold higher in renal transplant recipients compared with the GP.
After stratification for age, differences between groups decreased but
retained their magnitude.
Conclusion: Patients with
ESRD treated with dialysis have higher pulmonary infectious mortality
rates compared with the GP, even after stratification for age, race,
and DM. Consequently, this patient population must be considered at
high risk for the development of lethal pulmonary