Tuberculosis common in CKD patients

Patients with chronic kidney disease (CKD) appears to have a high incidence of tuberculosis (TB), with regional disparities, according to a study.

Researchers searched electronic and gray literature sources for studies that described the global and regional burden of TB in the CKD population. They used the PRISMA method to perform, the Joanna Briggs Institute critical appraisal checklist to assess the studies’ quality, and funnel plots and Egger's regression tests to assess publication bias.

The analysis included 104 studies, which involved a total of 1,548,774 CKD patients. Twenty-three studies were reported from countries categorized as high TB burden countries based on the 2021 Global TB Report.

The studies were conducted in six continents: Asia, Europe, Africa, South America, North America, Australia, and New Zealand. Based on the World Health Organization regional category, the studies were conducted in countries grouped under the African Region, Eastern Mediterranean Region, European Region, Region of the Americas, South-East Asian Region, and West Pacific Region.

The pooled TB incidence was estimated at 3,718/100,000, ranging from 60/100,000 in the UK to 19,270/100,000 in China. The African Region had the highest pooled TB incidence (9,952/100,000), followed by South-East Asian (7,200/100,000) and Eastern Mediterranean (5,508/100,000) regions.

Moreover, the incidence was higher among patients on haemodialysis (5,611/100,000) and on peritoneal dialysis (3,533/100,000) than among those who received renal transplantation (2,700/100,000) and predialysis patients (913/100,000).

Of note, extrapulmonary TB (2,227/100,000) was more common than pulmonary TB (1,786/100,000).

The findings underscore the importance of active TB screening in the CKD population.