Distribution and clinical course of infections in patients hospitalized with kidney failure

Acute and chronic kidney failure are diseases with increased incidence and high complication and mortality rates with advanced age. Acute kidney failure is seen in 1-5% of all hospital admissions and approximately 30% of intensive care patients. According to the records of the Turkish Society of Nephrology, the most common causes of mortality in acute renal failure are; cardiovascular diseases in the first place, infectious diseases in the second place, followed by respiratory failure and cerebrovascular events. The most common causes of mortality in hemodialysis patients are cardiovascular diseases, malignancy, cerebrovascular events and infectious diseases, respectively; The most common causes of mortality in patients with peritoneal dialysis are cardiovascular diseases, infectious diseases and cerebrovascular events, respectively. According to the records of the Turkish Society of Nephrology, cardiovascular diseases are the most common cause of mortality in both acute renal failure and chronic renal failure patients. In some studies, the most common cause of mortality has been documented as infectious diseases. Diagnosis of infection in kidney failure is difficult due to impaired immune response and the presence of chronic inflammation. Kidney failure can also be considered as acquired immune deficiency. Although serious infection may occur in patients, the fever may not increase, infection findings may be more mild. In this study, 426 patients with acute or chronic renal failure and infection suspicion at Namık Kemal University between december 2018 and march 2020 were followed. Of patients; demographic data, types of kidney dysfunction, progression in kidney function tests, presence of electrolyte imbalance, liver enzymes, fever and other infection parameters, leukocyte values in urine, culture results, antibiotic selection and necessity of change, focus of infection, mortality status, accompanying chronic disease and The presence of malignancy was recorded. In our study, parameters that will assist in revealing the presence of infection in patients with renal insufficiency and which may be a guide in terms of mortality have been introduced. The most important findings of our study, which differ from other studies, are that CRP is more effective than procalcitonin in revealing the presence of infection in patients with renal failure, the presence of positive correlation between AST and the presence of infection, monitoring of kidney function tests and revealing the amount of progression are both the presence of infection and the indicator of mortality. In terms of kidney failure, it was found that fever was not significant in infections in patients with renal insufficiency, ARF patients without chronic background had a higher mortality compared to CRF, and the presence of DM-HT or malignancy alone did not increase mortality.