Clinical Characteristics and Outcomes in Chronic Kidney Disease Patients with Tuberculosis in China: A Retrospective Cohort Study

作者全名："Xiao, Jing; Ge, Jianjian; Zhang, Dingxin; Lin, Xinqiang; Wang, Xiaoshuang; Peng, Li; Chen, Liqun"

作者地址："[Xiao, Jing; Ge, Jianjian; Zhang, Dingxin; Lin, Xinqiang; Wang, Xiaoshuang; Chen, Liqun] Chongqing Med Univ, Affiliated Hosp 1, Dept Nephrol, Chongqing 400016, Peoples R China; [Peng, Li] Chongqing Med Univ, Affiliated Hosp 1, Dept Resp, Chongqing 400016, Peoples R China; [Chen, Liqun] Chongqing Med Univ, Affiliated Hosp 1, Dept Nephrol, Youyi Rd 1, Chongqing 4000416, Peoples R China"

通信作者："Chen, LQ (通讯作者)，Chongqing Med Univ, Affiliated Hosp 1, Dept Nephrol, Youyi Rd 1, Chongqing 4000416, Peoples R China."

来源：INTERNATIONAL JOURNAL OF GENERAL MEDICINE

ESI学科分类：　

WOS号：WOS:000843659100001

JCR分区：Q2

影响因子：2.3

年份：2022

卷号：15

期号：　

开始页：6661

结束页：6669

文献类型：Article

关键词：chronic kidney disease; extrapulmonary TB; pulmonary TB; anti-TB therapy; treatment outcome; hemodialysis

摘要："Background: The diverse manifestations of tuberculosis (TB) in chronic kidney disease (CKD) patients can cause difficulty in diagnosis, delayed treatment, even death. Therefore, this study investigated the clinical characteristics and the risk factors for mortality in CKD patients with TB.Methods: This retrospective study included 167 patients diagnosed with active TB at two tertiary medical centers in Chongqing within six years. Clinical characteristics and outcomes of anti-TB treatment in patients with and without CKD were collected, and the predictive mortality values of variables were analyzed.Results: Of the 167 patients, 66.7% (44/66) hemodialysis (HD), 41.1% (21/51) pre-HD, and 32.0% (16/50) non-CKD patients had extrapulmonary TB. The pleura and lymph node were the common sites in CKD patients. Clinical presentations of cough and hemoptysis in CKD patients were less common than those in non-CKD patients, 13.7% (16/117) of CKD patients even not having any clinical symptoms. The positive rates of tuberculin skin test, TB-polymerase chain reaction and acid-fast bacilli in sputum in HD patients were lower than those in pre-HD and non-CKD patients (p<0.05). CKD patients were more prone to gastrointestinal and neurological side effects during anti-TB treatment. The mortality rates of non-CKD, pre-HD and HD patients was 6.1%, 31.9% and 37.3%, respectively. Multivariate Cox analysis revealed that age >= 40 years (HR: 5.871; p=0.019), hypoalbuminemia (HR:2.879; p=0.004), CKD stage 4-5 (HR:4.719; p=0.018) and HD (HR:6.13; p=0.005) were associated with mortality.Discussion: CKD patients with TB have atypical clinical manifestations and high mortality. Age, hypoalbuminemia, CKD stage 4-5, and HD were independent predictors of mortality."

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