| アブストラクト | BACKGROUND: People with end-stage kidney disease have an increased risk of active tuberculosis (TB). Previous systematic reviews have demonstrated that patients with chronic kidney disease (CKD) have increased risk of severe community-acquired infections. We investigated the association between CKD (prior to renal replacement therapy) and incidence of TB in UK General Practice. METHODS: Using the UK Clinical Practice Research Datalink, 242,349 patients with CKD (stages 3-5) (estimated glomerular filtration rate < 60 mL/min/1.73 m(2) for >/=3 months) between April 2004 and March 2014 were identified and individually matched (by age, gender, general practice and calendar time) to a control from the general population without known CKD. The association between CKD (overall and by stage) and incident TB was investigated using a Poisson regression analysis adjusted for age, gender, ethnicity, socio-economic status, chronic obstructive pulmonary disease (COPD) and diabetes. RESULTS: The incidence of TB was higher amongst patients with CKD compared to those without CKD: 14.63 and 9.89 cases per 100,000 person-years. After adjusting for age, gender, ethnicity, socio-economic status, diabetes and COPD, the association between CKD and TB remained (adjusted rate ratio [RR] 1.42, 95% confidence interval [CI] 1.01-1.85). The association may be stronger amongst those from non-white ethnic minorities (adjusted RR 2.83, 95%CI 1.32-6.03, p-value for interaction with ethnicity = 0.061). Amongst those with CKD stages 3-5, there was no evidence of a trend with CKD severity. CONCLUSIONS: CKD is associated with an increased risk of TB diagnosis in a UK General Practice cohort. This group of patients should be considered for testing and treating for latent TB. |
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| ジャーナル名 | BMC nephrology |
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| Pubmed追加日 | 2020/10/2 |
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| 投稿者 | Ruzangi, Judith; Iwagami, Masao; Smeeth, Liam; Mangtani, Punam; Nitsch, Dorothea |
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| 組織名 | Department of Non-Communicable Disease Epidemiology, London School of Hygiene and;Tropical Medicine, London, UK.;Tropical Medicine, London, UK. masao.iwagami@lshtm.ac.uk.;Department of Health Services Research, Faculty of Medicine, University of;Tsukuba, building #861, 1-1-1 Tenno-dai, Tsukuba, Ibaraki, Japan.;masao.iwagami@lshtm.ac.uk.;Department of Infectious Disease Epidemiology, London School of Hygiene and |
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| Pubmed リンク | https://www.ncbi.nlm.nih.gov/pubmed/32998703/ |
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