Fever in Hospitalized Patients With Incident End-Stage Renal Disease

摘要

BACKGROUND: Fever is not only a common cause but also a complication of hospitalization among patients with advanced chronic kidney disease (CKD). We were interested in the associated conditions with fever in hospitalized patients with incident end-stage renal disease (ESRD). METHODS: Between August 2010 and December 2016, we applied catastrophic illness card of ESRD for 1,095 patients. A total of 676 patients with admission history were eligible for analysis. We reviewed their charts and collected data, including demographic parameters, clinical characteristics, and laboratory results, on the first day of admission or when fever occurred during hospitalization. We identified the causes of fever and analyzed the variables associated with fever. RESULTS: The top 4 causes of fever were urinary tract infection, respiratory tract infection, gout attack and catheter-related infection in order. By univariate regression analysis, we identified body mass index (BMI), heart failure, malignancy, autoimmune disease, white blood cell (WBC) count, the presence of band form, hemoglobin, serum potassium, albumin levels, and hemodialysis (HD) catheter implantation were significantly associated with fever. By multivariate regression analysis, BMI, WBC count and serum albumin were the parameters most strongly associated with the development of fever (P< 0.001). CONCLUSION: Lower BMI, elevated WBC count and decreased serum albumin were strongly associated with the presence of fever (P < 0.001). Also, gout attack was the third common cause of fever, and the primary care physician should pay attention to it.