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