Tuberculosis rate in US patients with kidney failure 10-fold higher than those without
Key takeaways:
- Of 111,155 tuberculosis diagnoses, researchers found 2,892 patients had kidney failure.
- The annual tuberculosis rate ranged from 26.1 to 45.4 per 100,000 patients with kidney failure.
The tuberculosis rate among U.S. patients with kidney failure from 2010 to 2021 was 10-fold higher than that of the general population, researchers found.
Chronic kidney disease may disrupt T-cell function, “which increases the risk for infections, including infection with Mycobacterium tuberculosis,” Kimberly R. Schildknecht, MPH, of the division of tuberculosis elimination at the CDC in Atlanta, wrote with colleagues. “Following M. tuberculosis infection, many people develop lifelong latent infection; relatively few progress to tuberculosis disease. However, CKD confers a higher risk for progression.”
Researchers completed a nationwide cross-sectional descriptive analysis of tuberculosis cases reported to the National Tuberculosis Surveillance System during 11 years. All patients with tuberculosis were stratified by kidney failure status, and the study also compared qualities of patients with tuberculosis by kidney failure status.
Of 111,155 tuberculosis diagnoses, approximately 3% (2,892 patients) had kidney failure, according to the findings. The annual tuberculosis rate ranged from 26.1 to 45.4 per 100,000 patients with kidney failure compared with 2.1 to 3.5 per 100,000 people without kidney failure.
The study found 32% (924 patients) with kidney failure had extrapulmonary tuberculosis alone, and nearly 40% died. Of patients who died, 286 were diagnosed with tuberculosis posthumously and 792 died during treatment.
Schildknecht and colleagues further noted that patients with tuberculosis and kidney failure had twice the prevalence of false-negative results on the tuberculin skin test, with a prevalence rate of 39% vs. 20% for patients without kidney failure.
“Both tuberculosis and kidney failure disproportionally affect socioeconomically disadvantaged people in the United States, and understanding the relationship between these two diseases could inform interventions to prevent tuberculosis disease and associated morbidity,” the researchers wrote, adding that “all people with kidney failure receive regular screening for tuberculosis disease, especially at extrapulmonary sites, and regular testing and treatment for tuberculosis infection.”
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