Analysis of 8 chronic kidney disease patients complicated with Pneumocystis carinii pneumonia

Objective To study the clinical characteristics and outcome of Pneumocystis carinii pneumonia(PCP) in patients with chronic kidney diseases.Methods Clinical data of 8 cases of chronic kidney diseases complicated with PCP(excluding renal transplant patients) were examined retrospectively.Results The most common presenting symptoms at admission were fever(100%),cough without or with a little sputum(87.5%),and exertional dyspnea(75%).Beside these,they complained of chest tightness,fatigue,sweating and chills.Six patients(75%) presented with hypoxemia were diagnosed with type 1 respiratory failure during the course of illness.The most common CT feature was bilateral patchy areas of ground-glass opacities.Five patients had peripheral blood lymphocyte count less than 1 ×109/L.Four patients had CD4 cell count less than 200/mm3.Serum LDH level was elevated in 5 patients(582±222.55).Among the 8 patients,2 patients died within 20 days of PCP diagnosis.Conclusion Pneumocystis carinii pneumonia is an opportunistic and serious complication in chronic kidney disease patients treated with immunosuppressants.The disease progression is fast and patients with respiratory failure have a high mortality rate.Early diagnosis and appropriate treatment are important for better prognosis.

Objective To study the clinical characteristics and outcome of Pneumocystis carinii pneumonia （PCP） in patients with chronic kidney diseases. Methods Clinical data of 8 cases of chronic kidney diseases complicated with PCP （excluding renal transplant patients） were examined retrospectively. Results The most common presenting symptoms at admission were fever （100%）, cough without or with a little sputum （87.5%）, and exertional dyspnea （75%）. Beside these, they complained of chest tightness, fatigue, sweating and chills. Six patients （75%） presented with hypoxemia were diagnosed with type 1 respiratory failure during the course of illness. The most common CT feature was bilateral patchy areas of ground-glass opacities. Five patients had peripheral blood lymphocyte count less than 1 x 109/L. Four patients had CD4 cell count less than 200/mm~. Serum LDH level was elevated in 5 patients （582＋ 222.55）. Among the 8 patients, 2 patients died within 20 days of PCP diagnosis. Conclusion Pneumocystis carinii pneumonia is an opportunistic and serious complication in chronic kidney disease patients treated with immunosuppressants. The disease progression is fast and patients with respiratory failure have a high mortality rate. Early diagnosis and appropriate treatment are important for better prognosis.