Browse > Article
http://dx.doi.org/10.3346/jkms.2018.33.e341

End-stage Renal Disease and Risk of Active Tuberculosis: a Nationwide Population-Based Cohort Study  

Min, Jinsoo (Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Daejeon St. Mary's Hospital, College of Medicine, The Catholic University of Korea)
Kwon, Soon Kil (Department of Internal Medicine, Chungbuk National University College of Medicine)
Jeong, Hye Won (Department of Internal Medicine, Chungbuk National University College of Medicine)
Han, Joung-Ho (Department of Internal Medicine, Chungbuk National University College of Medicine)
Kim, Yeonkook Joseph (Graduate School of Health Science Business Convergence, Chungbuk National University College of Medicine)
Kang, Minseok (Department of Health Information and Management, Chungbuk National University College of Medicine)
Kang, Gilwon (Department of Health Information and Management, Chungbuk National University College of Medicine)
Publication Information
Journal of Korean Medical Science / v.33, no.53, 2018 , pp. 341.1-341.11 More about this Journal
Abstract
Background: The converging epidemics of tuberculosis (TB) and end-stage renal disease (ESRD) have generated a significant public health burden, however, previous studies have been limited to a small number of patients. This nationwide cohort study aimed to assess the rate of developing active TB among patients receiving dialysis for ESRD. Methods: The Korean national health insurance database was used to identify patients receiving dialysis for new-onset ESRD during 2004-2013, who were propensity score matched to an equivalent number of non-dialysis subjects from the general population. The incidences of active TB in the ESRD and control cohorts were calculated for 2004-2013, and multivariable Cox proportional hazards model was used to evaluate the ESRD-related risk of active TB. Results: During 2004-2013, 59,584 patients received dialysis for newly diagnosed ESRD. In the dialysis and control cohorts, 457 (0.8%) and 125 (0.2%) cases of active TB were detected, respectively. Patients with ESRD were associated with a significantly higher risk of active TB compared to the controls (incidence rate ratio, 4.80). The ESRD cohort had an independently elevated risk of active TB (adjusted hazard ratio, 4.39; 95% confidence interval, 3.60-5.37). Conclusion: We found that patients receiving dialysis for ESRD had an elevated risk of active TB. These results highlight the need for detailed and well-organised guidelines for active TB screening among patients with ESRD.
Keywords
Dialysis; Chronic Kidney Disease; Incidence; Korea;
Citations & Related Records
연도 인용수 순위
  • Reference
1 Li SY, Chen TJ, Chung KW, Tsai LW, Yang WC, Chen JY, et al. Mycobacterium tuberculosis infection of end-stage renal disease patients in Taiwan: a nationwide longitudinal study. Clin Microbiol Infect 2011;17(11):1646-52.   DOI
2 Hwang JH, Choe PG, Kim NH, Bang JH, Song KH, Park WB, et al. Incidence and risk factors of tuberculosis in patients with human immunodeficiency virus infection. J Korean Med Sci 2013;28(3):374-7.   DOI
3 Vestbo J, Hurd SS, Agusti AG, Jones PW, Vogelmeier C, Anzueto A, et al. Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease: GOLD executive summary. Am J Respir Crit Care Med 2013;187(4):347-65.   DOI
4 Vaziri ND, Pahl MV, Crum A, Norris K. Effect of uremia on structure and function of immune system. J Ren Nutr 2012;22(1):149-56.   DOI
5 Lee WC, Lee SY. National health screening program of Korea. J Korean Med Assoc 2010;53(5):363-70.   DOI
6 Hwang JA, Kim S, Jo KW, Shim TS. Natural history of Mycobacterium avium complex lung disease in untreated patients with stable course. Eur Respir J 2017;49(3):1600537.   DOI
7 Dheda K, Barry CE 3rd, Maartens G. Tuberculosis. Lancet 2016;387(10024):1211-26.   DOI
8 Couser WG, Remuzzi G, Mendis S, Tonelli M. The contribution of chronic kidney disease to the global burden of major noncommunicable diseases. Kidney Int 2011;80(12):1258-70.   DOI
9 Romanowski K, Clark EG, Levin A, Cook VJ, Johnston JC. Tuberculosis and chronic kidney disease: an emerging global syndemic. Kidney Int 2016;90(1):34-40.   DOI
10 Jin DC, Han JS. Renal replacement therapy in Korea, 2012. Kidney Res Clin Pract 2014;33(1):9-18.   DOI
11 Kato S, Chmielewski M, Honda H, Pecoits-Filho R, Matsuo S, Yuzawa Y, et al. Aspects of immune dysfunction in end-stage renal disease. Clin J Am Soc Nephrol 2008;3(5):1526-33.   DOI
12 Centers for Disease Control and Prevention (CDC). Tuberculosis transmission in a renal dialysis center--Nevada, 2003. MMWR Morb Mortal Wkly Rep 2004;53(37):873-5.
13 Kim KH, Tandi TE, Choi JW, Moon JM, Kim MS. Middle East respiratory syndrome coronavirus (MERS-CoV) outbreak in South Korea, 2015: epidemiology, characteristics and public health implications. J Hosp Infect 2017;95(2):207-13.   DOI
14 Chou KJ, Fang HC, Bai KJ, Hwang SJ, Yang WC, Chung HM. Tuberculosis in maintenance dialysis patients. Nephron 2001;88(2):138-43.   DOI
15 Richardson RM. The diagnosis of tuberculosis in dialysis patients. Semin Dial 2012;25(4):419-22.   DOI
16 Lee J, Lee JS, Park SH, Shin SA, Kim K. Cohort profile: the National Health Insurance Service-National Sample Cohort (NHIS-NSC), South Korea. Int J Epidemiol 2017.46(2):e15.   DOI
17 Austin PC. A comparison of 12 algorithms for matching on the propensity score. Stat Med 2014;33(6):1057-69.   DOI
18 Dobler CC, McDonald SP, Marks GB. Risk of tuberculosis in dialysis patients: a nationwide cohort study. PLoS One 2011;6(12):e29563.   DOI
19 Al-Efraij K, Mota L, Lunny C, Schachter M, Cook V, Johnston J. Risk of active tuberculosis in chronic kidney disease: a systematic review and meta-analysis. Int J Tuberc Lung Dis 2015;19(12):1493-9.   DOI
20 Hu HY, Wu CY, Huang N, Chou YJ, Chang YC, Chu D. Increased risk of tuberculosis in patients with end-stage renal disease: a population-based cohort study in Taiwan, a country of high incidence of end-stage renal disease. Epidemiol Infect 2014;142(1):191-9.   DOI
21 Segall L, Covic A. Diagnosis of tuberculosis in dialysis patients: current strategy. Clin J Am Soc Nephrol 2010;5(6):1114-22.   DOI
22 Munoz P, Rodriguez C, Bouza E. Mycobacterium tuberculosis infection in recipients of solid organ transplants. Clin Infect Dis 2005;40(4):581-7.   DOI
23 Quantrill SJ, Woodhead MA, Bell CE, Hardy CC, Hutchison AJ, Gokal R. Side-effects of antituberculosis drug treatment in patients with chronic renal failure. Eur Respir J 2002;20(2):440-3.   DOI
24 Gursu M, Tayfur F, Besler M, Kaptanogullari O, Kucuk M, Aydin Z, et al. Tuberculosis in peritoneal dialysis patients in an endemic region. Adv Perit Dial 2011;27:48-52.
25 Lui SL, Tang S, Li FK, Choy BY, Chan TM, Lo WK, et al. Tuberculosis infection in Chinese patients undergoing continuous ambulatory peritoneal dialysis. Am J Kidney Dis 2001;38(5):1055-60.   DOI