Clinical epidemiology of pneumonia in hemodialysis patients: the USRDS waves 1, 3, and 4 study

The clinical epidemiology of pneumonia in hemodialysis patients has received little attention. We linked the retrospective Waves 1, 3, and 4 Dialysis Morbidity and Mortality Study data sets (n=10635) to Medicare claims to identify hospitalizations with pneumonia. Mean patient age was 60.3 years and duration of end-stage renal disease (ESRD) 3.8 years; 41.1% of patients had diabetes mellitus. Only 31.6% had received influenza vaccination in the 4 months preceding the study start date (January 1, 1994). The cumulative probability of pneumonia hospitalization was 0.09 at 1 year and 0.36 at 5 years. The main associations of hospitalization with pneumonia were age 45–64 years and ≥65 years (adjusted hazards ratio (AHR) 1.26 and 1.48 vs