Characteristics of Pneumonia and Clinical Significance of Atelectasis in Patients with Chronic Kidney Disease Stage 5 / 대한신장학회지

ABSTRACT

PURPOSE: Pneumonia is a common condition in patients with chronic renal insufficiency, and the condition is closely associated with high mortality and hospitalization rate in such patients. However, limited information is available about the clinical course of pneumonia in these patients, particularly in those with coexistent pulmonary atelectasis. We studied the characteristics of pneumonia as well as the clinical significance of pulmonary atelectasis in patients with chronic renal insufficiency. METHODS: We retrospectively reviewed the medical records of 25 patients with chronic renal insufficiency that were diagnosed as having pneumonia with atelectasis. The clinical, laboratory and radiological findings in these patients were examined. We also assessed the severity of atelectasis in these patients and compared the clinical courses of patients with different grades of atelectasis. RESULTS: The mean age of the patients was 71 years, and 15 of the 25 patients (60%) had diabetes. On chest computed tomography, the incidence of lobar infiltration, atelectasis, and pleural effusion was 75%, 64%, and 56%, respectively. The incidences of severe pneumonia and death tended to increase with the severity of atelectasis; however the increase was not statistically significant. The incidence of recurrence of pneumonia was significantly higher in patients with severe atelectasis than that in those without atelectasis. CONCLUSION: The incidence of severe pneumonia and the mortality rate tended to be higher in patients with severe atelectasis than in those without atelectasis. In addition, severe atelectasis was associated with the recurrence of pneumonia in patients with chronic renal insufficiency.