Infection and Immunodeficiency in Patients With Chronic Kidney Disease: Current Evidence and Potential Preventive Strategies of Chinese Medicine

Cardiovascular disease and infections significantly contribute to high mortality and morbidity in patients with chronic kidney disease (CKD). Despite extensive research on cardiovascular complications, infection-related aspects in CKD have received limited attention. This review systematically synthesizes current evidence on the causes and consequences of infections in CKD patients. We focus on immunodeficiency as a primary factor in increased infection susceptibility and examine the clinical outcomes associated with infections in this population. Regarding causes, CKD patients exhibit heightened vulnerability to infections for secondary immunodeficiency related to kidney disease (SIDKD). Regarding its consequences, we review studies on the association between reduced kidney function and adverse outcomes, including hospitalizations, acute kidney injury, cardiovascular events, progression to end-stage kidney disease, infections caused by multidrug-resistant organisms. Infections in CKD patients are associated with increased mortality across different infection types. Infection-related complications are a critical concern in CKD management. We recommend further research to develop effective preventive strategies, including potential interventions involving Chinese medicine, to reduce infection risks in this high-risk population.