Risk factors and prognosis for latent tuberculosis infection in dialysis patients: A retrospective cohort study at a single tertiary care center

Xia, Yun1,2; Fan, Qiuxia3; Zhang, Jieyun4; Jiang, Li5; Huang, Xiaoyan1; Xiong, Zuying1; Xiong, Zibo1,6

2023-02-01

10.1111/sdi.13150

SEMINARS IN DIALYSIS   Impact Factor & Quartile

0894-0959

1525-139X

IntroductionRecent studies report that latent tuberculosis infection (LTBI) may lead to an increased risk of cardiovascular disease (CVD) that led us to hypothesize that LTBI may play an important role in major adverse cardiovascular events (MACE) in dialysis patients. MethodsA single-center retrospective cohort study was conducted. A total of 270 patients undergoing hemodialysis or peritoneal dialysis more than 3 months were included. The interferon enzyme-linked immunospot (IFN-gamma ELISPOT) assay was used for the diagnosis of LTBI. Primary endpoints were MACE, including all-cause death and acute coronary syndrome (ACS). The association between LTBI and MACE was examined using multivariate Cox proportional hazards regression after adjusting for covariates and Kaplan-Meier survival analysis. ResultsIn our study, the patients were classified into LTBI (n = 47) or non-LTBI (n = 223) groups. Independent risk factors for LTBI in dialysis population were prior tuberculosis (TB) history (odds ratio [OR] 4.817 [1.064-22.306]), tobacco use (OR 2.903 [1.155-7.299]), and older age (OR 1.027 [1.002-1.053]). After a median follow-up of 39 months, the incidence of active TB was 6.4% versus 0% in dialysis patients with and without LTBI, respectively (p = 0.005). Multivariate Cox analysis showed that LTBI was significantly associated with MACE (hazard ratio [HR] 2.540 [1.490-4.350]) after adjustment for potential confounders. ConclusionsPrior TB history, tobacco use, and the elderly can be used to select cost-effective LTBI screening target groups in dialysis patients. LTBI is not only closely related to active TB but also an independent risk factor for higher incidence of MACE in dialysis population.

SCI

English

Others

Urology & Nephrology

Urology & Nephrology

WOS:000937404300001

WILEY

CLINICAL MEDICINE

Web of Science

1.Peking Univ, Renal Div, Shenzhen Hosp, Shenzhen, Peoples R China
2.Shenzhen Luohu Dist Tradit Chinese Med Hosp, Renal Div, Shenzhen, Peoples R China
3.Sun Yat sen Univ, Affiliated Hosp 8, Renal Div, Shenzhen, Peoples R China
4.Affiliated Shenzhen Third Hosp, Guangdong Key Lab Diag & Treatment Emerging Infect, Shenzhen, Peoples R China
5.Southern Univ Sci & Technol, Dept Stat & Data Sci, Shenzhen, Peoples R China
6.Peking Univ, Renal Div, Shenzhen Hosp, Lianhua Rd 1120, Shenzhen 518036, Guangdong, Peoples R China

Xia, Yun,Fan, Qiuxia,Zhang, Jieyun,et al. Risk factors and prognosis for latent tuberculosis infection in dialysis patients: A retrospective cohort study at a single tertiary care center[J]. SEMINARS IN DIALYSIS,2023.

Xia, Yun.,Fan, Qiuxia.,Zhang, Jieyun.,Jiang, Li.,Huang, Xiaoyan.,...&Xiong, Zibo.(2023).Risk factors and prognosis for latent tuberculosis infection in dialysis patients: A retrospective cohort study at a single tertiary care center.SEMINARS IN DIALYSIS.

Xia, Yun,et al."Risk factors and prognosis for latent tuberculosis infection in dialysis patients: A retrospective cohort study at a single tertiary care center".SEMINARS IN DIALYSIS (2023).