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Progression of chronic kidney disease and the risk of tuberculosis: an observational cohort study

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Little is known about tuberculosis (TB) risk in the earlier stages of chronic kidney disease (CKD).

To investigate the relationship between CKD at all stages and the risk of incident TB.

We conducted a cohort study using 100 058 participants of a community-based health screening programme in northern Taiwan, 2005–2008. Renal function was ascertained at baseline using serum creatinine level and the urine dipstick test. The occurrence of active TB was ascertained using the National Tuberculosis Registry. Cox proportional hazards regression was used to estimate the association between CKD and TB.

During a median follow-up of 7.5 years, the number of TB incident cases was 472. In the Cox regression analyses, individuals with Stage 1–4 CKD had a 25% increase in TB hazard than those without disease (adjusted hazard ratio [aHR] 1.25, 95%CI 1.02–1.54). A positive correlation between CKD stage and TB was observed (P = 0.02 for trend). TB risk increased by 5.1% with every 10 ml/min/1.73 m2 decrease in the estimated glomerular filtration rate (aHR 1.05, 95%CI 0.99–1.12).

Our results suggested an increased risk of TB in early-stage CKD. TB prevention efforts should consider individuals with earlier stages of CKD.
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Keywords: estimated glomerular filtration rate; longitudinal study; renal function

Document Type: Research Article

Affiliations: 1: School of Public Health, University of California, Berkeley, Berkeley, California, USA 2: Institute of Epidemiology and Preventive Medicine, National Taiwan University, Taipei 3: Division of Respirology, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Centre for Disease Control, Vancouver, British Columbia, Canada 4: Institute of Epidemiology and Preventive Medicine, National Taiwan University, Taipei, Division of Nephrology, Department of Internal Medicine, Shuang Ho Hospital, Division of Nephrology, Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei 5: Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan

Publication date: May 1, 2019

More about this publication?
  • The International Journal of Tuberculosis and Lung Disease publishes articles on all aspects of lung health, including public health-related issues such as training programmes, cost-benefit analysis, legislation, epidemiology, intervention studies and health systems research. The IJTLD is dedicated to the continuing education of physicians and health personnel and the dissemination of information on tuberculosis and lung health world-wide.

    Certain IJTLD articles are selected for translation into French, Spanish, Chinese or Russian. They are available on the Union website

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