ObjectiveTo explore the clinical and prognostic characteristics of chronic kidney disease （CKD） patients with Pneumocystis jirovecii pneumonia （PJP）， thus facilitating the diagnosis and treatment of Pneumocystis jirovecii infections.MethodsWe retrospectively analyzed the clinical date of 22 CKD patients with PJP who were hospitalized in the First Affiliated Hospital with Nanjing Medical University and diagnosed by metagenomic next-generation sequencing （mNGS） from October 1， 2019 to October 31， 2023. Based on the prognosis， CKD patients with PJP were divided into the cured group （n=14） and death group （n=8）. The clinical characteristics， laboratory examination indicators， and disease treatment situations of the two groups of patients were compared.ResultsA total of 22 CKD patients were diagnosed with PJP， including 6 males （27.3%） and 16 females （72.7%）. The mean age was （57.1 ± 16.3） years. The primary underlying diseases were membranous nephropathy， immunoglobulin A nephropathy （IgAN）， lupus nephritis，antineutrophil cytoplasmic antibody （ANCA）-associated glomerulonephritis. The median time of PJP was 3 （2， 108） months after the diagnosis of nephropathy. Totally 16 （72.7%） patients developed type Ⅰ respiratory failure. All patients had a history of glucocorticoids or immunosuppressants use 3 months prior to PJP. CT findings included mixed ground-glass opacities type and nodular type （81.8%）. Lactate dehydrogenase （LDH） was elevated in all patients. The 1，3-β-glucan test was positive in 18 patients （81.8%）. Lymphocyte count was low in 16 patients （72.7%）. The cluster of differentiation 4 receptors （CD4） cell count averaged at 292.3 cells/μL， and 60.0% of the patients had CD4 cell count