Effect of chronic kidney disease on all-cause mortality in tuberculosis disease: an Australian cohort study

BMC Infectious Diseases

Esther M. Briganti¹  Grant A. Jenkin²  Beau Z. Carr²  Joseph Musemburi³  Justin T. Denholm⁴ 

[1] Department of Epidemiology and Preventive Health, Monash University, Melbourne, Australia;Department of Infectious Diseases, Monash Health, Melbourne, Australia;Victorian Tuberculosis Program, Melbourne Health, Melbourne, Australia;Victorian Tuberculosis Program, Melbourne Health, Melbourne, Australia;Department of Infectious Diseases, University of Melbourne, Parkville, Australia;

关键词: Chronic kidney disease;    CKD;    Diabetes;    Mortality;    TB;    Tuberculosis;   

DOI  :  10.1186/s12879-022-07039-5

来源: Springer

【 摘 要 】

BackgroundWhile there has been a recent epidemiological and clinical focus on the interaction between diabetes and tuberculosis, the interaction between chronic kidney disease and tuberculosis has been less studied. In particular, little is known of the effect of eGFR levels well above that seen in end stage kidney disease on mortality.MethodsWe conducted a retrospective cohort study of 653 adults from a large Australian hospital network, using data from a state-wide registry of reported tuberculosis cases between 2010 and 2018, with ascertainment of diabetes status and renal function data from hospital medical records and laboratory data. Cox proportional hazards regression models were used to calculate hazard ratios for all-cause mortality associated with categories of chronic kidney disease in adults with tuberculosis disease.ResultsTotal number of deaths was 25 (3.8%). Compared to tuberculosis cases with eGFR ≥ 60 ml/min, all-cause mortality was higher for those with chronic kidney disease from an eGFR level of 45 ml/min. The association was independent of sex, age and diabetes status with adjusted hazard ratio of 4.6 (95% CI: 1.5, 14.4) for eGFR 30–44 ml/min and 8.3 (95% CI: 2.9, 23.7) for eGFR < 30 ml/min.ConclusionsOur results suggest a notably increased risk of all-cause mortality even in those with more moderate degrees of renal impairment, in a low tuberculosis prevalence setting. The impact of these findings on a population basis are at least as significant as that found with diabetes and warrant further investigation in populations with higher tuberculosis prevalence.

【 授权许可】

CC BY