Analysis Of Risk Factors For Pulmonary Infection After Renal Transplantation

Objective:To analyze the high risk factors of pulmonary infection in patients with postoperative renal transplantation,and to provide evidence for prevention,early diagnosis and etiology of lung infection after renal transplantation.Methods:The study was a case-control study.Thirty patients with pulmonary infection during hospitalization from January 2014 to December 2018 in our hospital were selected as the case group.119 cases without pulmonary infection after renal transplantation were selected as the control group.General data(name,sex,age,ethnicity,height,weight,type and time of preoperative dialysis,kidney source)and laboratory data(white blood cells,neutrophil percentage,lymphocyte percentage,monocyte percentage,percentage of eosinophils,percentage of basophils,red blood cells,hemoglobin,platelets,serum albumin,CRP,PCT,prothrombin time,fibrinogen,lymphocyte subset analysis,and sputum culture results,etc.)were collected.Univariate analysis was used to include variables with P less than or equal to 0.1 in a multivariate analysis to analyze possible independent risk factors.Results:1.There were 21 males and 9 females in the case group;88 males and 31 females in the control group.There were 29 cases(96.67%)in hemodialysis and 1 case(3.33%)in peritoneal dialysis in the case group;108 cases(90.76%)in hemodialysis and 11 cases(9.24%)in peritoneal dialysis in the control group.2.Bacteria are the most common pathogens of lung infection after kidney transplantation,accounting for 43.33%(13/30),the second place of fungi,accounting for 30.00%(9/30),and the negative culture accounting for 20.00%(6/30).Mixed infection accounted for 6.67%(2/30),mainly bacteria+fungi.3.Univariate analysis showed:There were no statistically differences in ethnicity(P=0.06),transplanted kidney source(P=0.07),preoperative white blood cells(P=0.06),preoperative neutrophils(P=0.10),preoperative NLR(neutrophil to lymphocyte ratio)(P=0.06))。Multivariate analysis showed that the risk of pulmonary infection was lower in the Han nationality(OR=0.316,95%CI:0.126-0.792,P=0.014),and the risk of pulmonary infection was higher when preoperative NLR greater than 3.0(OR=3.586,95%CI:1.420-9.054,P=0.007).Conclusions:1.Bacteria are the most common pathogens of lung infection after kidney transplantation,and fungi rank second.2.Preoperative NLR greater than 3.0 is an independent risk factor for pulmonary infection after renal transplantation.Minority factors may be one of the risk factors for pulmonary infection after renal transplantation.