Chronic Kidney Disease and End Stage Renal Disease are Risk Factors for Poor Outcomes of Clostridium Difficile Infection: A Systematic Review and Meta-analysis

Charat Thongprayoon; Wisit Cheungpasitporn; Parkpoom Phatharacharukul; Peter J. Edmonds; Quanhathai Kaewpoowat; Pailin Mahaparn; Jackrapong Bruminhent; Stephen B. Erickson

doi:10.1111/ijcp.12672

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Chronic Kidney Disease and End Stage Renal Disease are Risk Factors for Poor Outcomes of Clostridium Difficile Infection: A Systematic Review and Meta-analysis

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Chronic Kidney Disease and End Stage Renal Disease are Risk Factors for Poor Outcomes of Clostridium Difficile Infection: A Systematic Review and Meta-analysis

Charat Thongprayoon, Wisit Cheungpasitporn, Parkpoom Phatharacharukul, Peter J. Edmonds, Quanhathai Kaewpoowat, Pailin Mahaparn, Jackrapong Bruminhent and Stephen B. Erickson

International journal of clinical practice (Esher), Vol.69(9), pp.998-1006

07/05/2015

DOI: 10.1111/ijcp.12672

PMCID: PMC4552593

PMID: 26147121

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Abstract

Background The objective of this systematic review and meta-analysis was to assess the clinical outcomes of Clostridium difficile infection (CDI) in patients with chronic kidney diseases (CKD) and end-stage renal disease (ESRD). Methods A literature search was performed from inception through February 2015. Studies that reported relative risks, odds ratios or hazard ratios comparing the clinical outcomes of CDI in patients with CKD or ESRD and those without CKD or ESRD were included. Pooled risk ratios (RRs) and 95% confidence intervals (CIs) were calculated using a random-effect, generic inverse variance method. Results Nineteen studies (a case-control and 18 cohort studies) with 116,875 patients assessing clinical outcomes of CDI were included in the meta-analysis. Pooled RR of severe or complicated CDI in CKD patients was 1.51 (95% CI: 1.00-2.28). The risk of recurrent CDI is significant higher in patients with a pooled RR of 2.73 (95% CI: 1.36-5.47). The pooled RR of mortality risk of CDI in patients with CKD, ESRD and CKD or ESRD were 1.76 (95% CI: 1.26-2.47), 1.58 (1.37-1.83) and 1.76 (1.32-2.34) respectively. Conclusion This meta-analysis demonstrates poor outcomes of CDI including severe and recurrent CDI in CKD patients. History of CKD and ESRD are both associated with increased mortality risk in patients with CDI.

c difficile

c. diff infection

chronic kidney disease

Clostridium

Clostridium difficile

Clostridium difficile–associated colitis

dialysis

diarrhea

end stage kidney disease

Infection

Infectious disease

Meta-analysis

outcome

severity

Details

Title: Subtitle: Chronic Kidney Disease and End Stage Renal Disease are Risk Factors for Poor Outcomes of Clostridium Difficile Infection: A Systematic Review and Meta-analysis
Creators: Charat Thongprayoon - Mayo Clinic
Wisit Cheungpasitporn - Mayo Clinic
Parkpoom Phatharacharukul - University of Minnesota
Peter J. Edmonds - SUNY Upstate Medical University
Quanhathai Kaewpoowat - SUNY Upstate Medical University
Pailin Mahaparn - Chulalongkorn University
Jackrapong Bruminhent - Ramathibodi Hospital
Stephen B. Erickson - Mayo Clinic
Resource Type: Journal article
Publication Details: International journal of clinical practice (Esher), Vol.69(9), pp.998-1006
DOI: 10.1111/ijcp.12672
PMID: 26147121
PMCID: PMC4552593
NLM abbreviation: Int J Clin Pract
ISSN: 1368-5031
eISSN: 1742-1241
Grant note: DOI: 10.13039/100006108, name: National Center for Advancing Translational Sciences, award: UL1 TR000135
Language: English
Date published: 07/05/2015
Academic Unit: Internal Medicine
Record Identifier: 9984359792302771

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