The effect of renal function on the febrile response to bacteremia

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Abstract
The febrile responses of 73 bacteremic patients were retrospectively studied using peak temperatures and 24 h areas under the fever curve on the day of the positive cultures. These responses were compared to their respective creatinine clearances calculated with the Nielsen-Hansen nomogram. Patients with clearances .gtoreq. 80 ml/min had a significantly greater febrile response than those with clearances .ltoreq. 29 ml/min (P < .025). Patients with clearances between these groups had responses that were in a mid-position but not significantly different from either group. Patients with impaired renal function may manifest fever in response to infection, but that it is quantitatively less than those with normal renal function. Because of this blunted response, minimal elevations of temperature in such patients warrant a diligent search for the presence of infection.