The objective of this study was to conduct a systematic evaluation of the risk factors and causative flora associated with combined lung infections in maintenance hemodialysis patients with end-stage renal disease. A comprehensive search was conducted across multiple databases, including VIP, Wan Fang, CNKI, CBM, Embase, The Cochrane Library, Web of Science, and PubMed. The objective was to identify and collate information on the risk factors associated with combined lung infections in patients with chronic renal failure. Additionally, case-control and cohort studies on the risk factors of pulmonary infections in patients with chronic renal failure and the flora of infections were sought. Two independent evaluators conducted the literature screening, quality assessment, and data extraction. The meta-analysis was performed using Revman 5.4 and Stata 15.0 software. A total of 21 papers were included in the study, of which 17 were case-control studies, and four were cohort studies. The total number of patients included in the study was 3004, with 1018 of them having pulmonary infections, resulting in an infection rate of 33%. The proportion was 59%. A meta-analysis of 33 potential risk factors revealed that age, body mass index (BMI), history of diabetes mellitus, C-reactive protein (CRP), serum albumin (ALB), hemoglobin (HGB), urea reduction rate (URR), and urea clearance index (KT/V) were significantly associated with the development of pulmonary infections. Risk factors were identified as significant for developing combined lung infections in patients with end-stage renal disease (ESRD) undergoing maintenance hemodialysis (MHD): cardiothoracic ratio, disease duration, age at dialysis, average weekly dialysis time, and dialysis modality. The most prevalent bacteria associated with lung infections were gram-negative bacteria, with Klebsiella pneumoniae, Pseudomonas aeruginosa, and Hemophilus influenzae representing the top three in terms of prevalence. The most prevalent pathogens were Pseudomonas aeruginosa and Hemophilus influenzae. The incidence of pulmonary infections in maintenance hemodialysis patients with end-stage renal disease is high. Identifying risk factors for the development of lung infections in patients with this disease and the subsequent development of interventions can help reduce the prevalence of lung infections. Given the limitations of the quantity and quality of existing literature, further high-quality studies are needed to validate the above conclusions.

Feng Li, Changhao Hu, Huan Liu, Xu Luo. Meta-analysis of Risk Factors for Pulmonary Infections in End-stage Maintenance Hemodialysis Patients. Academic Journal of Medicine & Health Sciences (2024), Vol. 5, Issue 11: 19-34. https://doi.org/10.25236/AJMHS.2024.051104.

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