Chronic Kidney Disease Correlates With Increased Risk of Tuberculosis Diagnosis

Sarfaroj Khan 

Disclosures

October 08, 2020

Takeaway

  • This study found an increased risk of tuberculosis (TB) in patients with chronic kidney disease (CKD) not requiring renal replacement therapy compared with patients without CKD.

  • There was no evidence that the rate of incident TB diagnosis varied with severity of kidney function.

  • The association of CKD with TB appeared stronger in patients of non-white ethnicity.

Why this matters

  • Findings are beneficial to UK policy seeking to identify high-risk CKD patients in primary care to test and treat for latent TB.

  • Findings warrant further research investigating the association between CKD and TB in patients of non-white ethnicity.

Study design

  • This study included 238,513 patients with CKD (stages 3-5; estimated glomerular filtration rate <60 mL/min/1.73m2 for ≥3 months) and 238,699 matched participants without CKD using data from the UK Clinical Practice Research Datalink (2004-2014).

  • Association between CKD (overall and by stage) and incident TB was evaluated.

  • Funding: Wellcome Trust.

Key results

  • The overall incidence of TB was higher in patients with CKD vs those without (incidence rate, 14.63 vs 9.89 per 100,000 person-years).

  • CKD positively associated with incident TB diagnosis after adjusting for age, gender, ethnicity, socio-economic status, chronic obstructive pulmonary disease and diabetes (adjusted rate ratio [aRR], 1.42; 95% CI, 1.09-1.85; P=.008).

  • This association appeared stronger in those from non-white ethnic minorities (aRR, 2.83; 95% CI, 1.32-6.03; P=.007; Pinteraction=.061).

  • In patients with CKD stages 3-5, there was no evidence of a trend with CKD severity (P=.541).

Limitations

  • Potential of non-differential misclassification of TB.

 

Ruzangi J, Iwagami M, Smeeth L, Mangtani P, Nitsch D. The association between chronic kidney disease and tuberculosis; a comparative cohort study in England. BMC Nephrol. 2020;21(1):420. doi: 10.1186/s12882-020-02065-4. PMID: 32998703 View full text

This clinical summary originally appeared on Univadis, part of the Medscape Professional Network.

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