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ORIGINAL RESEARCH article
Front. Med.
Sec. Pulmonary Medicine
Volume 12 - 2025 | doi: 10.3389/fmed.2025.1521879
Clinical characteristics of Pneumocystis jirovecii Pneumonia in hemodialysis patients
Provisionally accepted
NA YOUNG KIM 1
So Jeong Kim 1 Yohwan Yeo 1
Taehee KIM 2 Ji-Young Park 3 Jeong-Hee Choi 1 Chang Youl Lee 4
Soo Jie Chung 1*
Junghyun Kim 1*- 1 Hallym University Dongtan Sacred Heart Hospital, Hwaseong, Republic of Korea
- 2 Hallym University Kangnam Sacred Heart Hospital, Seoul, Republic of Korea
- 3 Hallym University Sacred Heart Hospital, Anyang-si, Gyeonggi, Republic of Korea
- 4 Chuncheon Sacred Heart Hospital, Hallym University, Chuncheon, Gangwon, Republic of Korea
Background: Limited research exists on Pneumocystis jirovecii pneumonia (PJP) in hemodialysis (HD) patients. This retrospective study aimed to compare clinical features and outcomes of PJP in HD and non-HD patients.Methods: We retrospectively analyzed 10 HD PJP cases and 40 non-HD PJP cases which were matched propensity scoring. Criteria included respiratory symptoms, new pulmonary infiltrates, and positive Pneumocystis real-time PCR. HD PJP patients were excluded if they were taking immunosuppressants, receiving solid organ transplant, treatment for hematological or solid cancer, HIV infection, or Pneumocystis jirovecii colonization, which was not an actual infection. Results: No significant differences in symptoms and radiological findings were observed between HD and non-HD PJP cases. Fever was the main symptom in both groups, ground glass opacity was the main finding on CT, and there was no significant difference between the two groups in blood test results. Although the partial pressure of oxygen/fraction of inspired oxygen (PaO2/FiO2) ratio and SpO2/FiO2 ratio exhibited lower averages in the HD group, there was no significant difference between the two groups (p=0.562 and 0.693 respectively). HD PJP patients exhibited delayed time to treatment marginally (5.3±2.3 days vs. 3.0±3.8 days, p=0.051) and duration of treatment was longer than non-HD PJP (18.3±3.2 days vs. 13.5±7.5 days, p=0.015). The length of stay, in-hospital mortality, and PJP-related death rate did not differ between HD PJP and non-HD PJP (p=0.382, 0.724, and 1.000 respectively). Conclusion: Our study highlights that HD patients with PJP may encounter delays in diagnosis and treatment compared to non-HD PJP patients.
Keywords: end-stage renal disease, hemodialysis, Pneumocystis pneumonia, Risk factors, Pneumocystis carinii (jiroveci)
Received: 03 Nov 2024; Accepted: 24 Mar 2025.
Copyright: © 2025 YOUNG KIM, Kim, Yeo, KIM, Park, Choi, Lee, Chung and Kim. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Soo Jie Chung, Hallym University Dongtan Sacred Heart Hospital, Hwaseong, Republic of Korea
Junghyun Kim, Hallym University Dongtan Sacred Heart Hospital, Hwaseong, Republic of Korea
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