Immunological risc factors for acute kidney damage in patients with pneumonia

Purpose of the study was to assess the immunological parameters in patients with pneumonia and CKD in the background and to determine their significance in the development of acute kidney injury. Materials and methods: 120 patients with acute pneumonia were examined: 40 patients with pneumonia (group Pn) and 80 patients with pneumonia developed on the background of chronic kidney disease (group Pn+CKD); 20 healthy individuals were examined as a control group (CG). The number of leukocytes was increased in the group of Pn+CKD by 162.24% compared to the CG (p<0.001) although was 27.79% lower than in the group of Pn (p<0.001). In patients with Pn, the ratio of the number of neutrophils to lymphocytes increased significantly, and in the group of Pn+CKD, it remained unchanged, despite an increase in the absolute number of leukocytes. In patients with pneumonia with CKD in the background, the most pronounced increase in the proportion of T-lymphocytes was observed due to a subpopulation of CD8 and CD95 cells (p<0.001 compared with CG and the Pn group) and the prevalence of an increase in IgG (p<0.001). Among 120 patients with pneumonia included in the study, 97 patients (80.83%) were diagnosed with acute kidney injury (AKI): in 75 patients - the 1st stage, in 15 patients the 2nd stage and in 7 patients the 3rd one. In the group of patients with pneumonia without background renal pathology, AKI was diagnosed in 23 patients (57.5%), in the group of Pn+CKD - in 68 patients (85%, chi-square=10.80, p<0.01). Immune predictors of AKI development depending on the development of AKI and its severity were determined by a retrospective analysis of the studied parameters. Conclusion: pneumonia associated with CKD is associated with the depletion of the cellular component of nonspecific immunity, activation of acquired immunity due to chronic inflammation and chronic antigenic stimulation. In patients with pneumonia, background chronic kidney disease, high levels of reactive and antibody-producing lymphocytes, monocytes, immature granulocytes and IgG CICs and decreased levels of neutrophils and IgM CICs were predictors of AKI.

пневмония, функциональное состояние почек, острое повреждение почек, хронический болезнь почек, иммунограмма, pneumonia, functional state of the kidneys, acute kidney injury, chronic kidney disease, immunogram

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