Clostridium difficile-associated diarrhea in dialysis patients.
- Author:
Sook Eui OH
1
;
Seung Min LEE
;
Young Ki LEE
;
Sun Ryoung CHOI
;
Myung Jin CHOI
;
Jwa Kyung KIM
;
Young Rim SONG
;
Soo Jin KIM
;
Tae Jin PARK
;
Sung Gyun KIM
;
Jieun OH
;
Jang Won SUH
;
Jong Woo YOON
;
Ja Ryong KOO
;
Hyung Jik KIM
;
Jung Woo NOH
Author Information
1. Department of Internal Medicine, Hallym Kidney Research Institute, Hallym University College of Medicine, Seoul, Korea. km2071@unitel.co.kr
- Publication Type:Original Article
- Keywords:
Antibiotics;
Chronic kidney disease;
Clostridium difficile;
Dialysis
- MeSH:
Anti-Bacterial Agents;
Clostridium;
Clostridium difficile;
Defense Mechanisms;
Dialysis;
Diarrhea;
Humans;
Multivariate Analysis;
Prevalence;
Renal Insufficiency, Chronic;
Retrospective Studies;
Risk Factors
- From:Kidney Research and Clinical Practice
2013;32(1):27-31
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND: Dialysis patients have impaired host defense mechanisms and frequently require antibiotics for various infective complications. In this study, we investigated whether dialysis patients have greater risk for Clostridium difficile-associated diarrhea (CDAD). METHODS: During the 4-year study period (2004-2008), 85 patients with CDAD were identified based on a retrospective review of C difficile toxin assay or histology records. Nosocomial diarrheal patients without CDAD were considered as controls (n=403). We assessed the association between renal function and the prevalence and clinical outcomes of CDAD. RESULTS: There was a significant difference in the prevalence rate of chronic kidney disease (CKD) between CDAD and non-CDAD patients (P<0.001). Sixteen patients (18.8%) of the CDAD group were treated with dialysis, whereas 21 patients (5.2%) of the non-CDAD group were treated with dialysis. There was a significant association between renal function and CDAD in patients on dialysis [odds ratio (OR)=4.44, 95% confidence interval (CI) 2.19-8.99, P<0.001], but not in patients with CKD stage 3-5 (OR=1.10, 95% CI 0.63-1.92, P=0.73). In multivariate analysis, CKD stage 5D was an independent risk factor for the development of CDAD (OR=13.36, 95% CI 2.94-60.67, P=0.001). CONCLUSION: Our data indicate that dialysis patients might be at a greater risk of developing CDAD, which suggests that particular attention should be provided to CDAD when antibiotic treatment is administered to dialysis patients.
