Risk factors of latent tuberculosis among chronic kidney disease with routine haemodialysis patients

Introduction: Since immune system alteration occurs, chronic kidney disease (CKD) on routine haemodialysis (HD) patients have a greater risk for latent tuberculosis (LTB). LTB needs special attention so that it does not develop into an active form, because infection in CKD patients increases the mor...

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Main Authors: Ria Bandiara, Astried Indrasari, Anggi Dewi Rengganis, Lilik Sukesi, Afiatin Afiatin, Prayudi Santoso
Format: Article
Language:English
Published: Elsevier 2022-05-01
Series:Journal of Clinical Tuberculosis and Other Mycobacterial Diseases
Subjects:
Online Access:http://www.sciencedirect.com/science/article/pii/S2405579422000079
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author Ria Bandiara
Astried Indrasari
Anggi Dewi Rengganis
Lilik Sukesi
Afiatin Afiatin
Prayudi Santoso
author_facet Ria Bandiara
Astried Indrasari
Anggi Dewi Rengganis
Lilik Sukesi
Afiatin Afiatin
Prayudi Santoso
author_sort Ria Bandiara
collection DOAJ
description Introduction: Since immune system alteration occurs, chronic kidney disease (CKD) on routine haemodialysis (HD) patients have a greater risk for latent tuberculosis (LTB). LTB needs special attention so that it does not develop into an active form, because infection in CKD patients increases the mortality. This study aims to determine the risk factors that associated with LTB among CKD on routine HD patients. Methods: This was a cross-sectional study conducted in Haemodialysis Unit, Hasan Sadikin General Hospital, Bandung. The subjects were recruited from March–May 2020. Subjects aged > 18 years at least have undergoing HD in 3 months and twice a week HD were included in this study. Patients with active tuberculosis (TB) suspected, malignancy, or immunocompromised were excluded. LTB was diagnosed using interferon-γ release assays (IGRA). All data including age, sex, CKD etiologies, smoking status, HD adequacy that assessed using KT/V and urea reduction ratio (URR), and contact status with TB patients were obtained and recorded in case report form. Results: A total of 120 subjects were involved. LTB based on IGRA was occurred in 39.2% subjects, while 56.7% and 4.1% subjects had negative and indeterminate IGRA, respectively. Adequacy of HD based on KT/V value was not significantly different between positive and negative IGRA subjects. Positive IGRA subjects had lower URR (p = 0.042). Smoking status had significant association with LTB (OR = 2.5[95%CI 1.2–5.4, p = 0.017). Furthermore, URR < 73% also had significant association with LTB (OR = 2.6[1.2–5.6, p = 0.013). Conclusion: Smoking status and HD adequacy based on URR < 73% are associated factors that contribute to LTB among CKD on HD patients.
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spelling doaj.art-b4b0ac760e3b4a129d58e5a7a4b245cd2022-12-22T00:22:41ZengElsevierJournal of Clinical Tuberculosis and Other Mycobacterial Diseases2405-57942022-05-0127100302Risk factors of latent tuberculosis among chronic kidney disease with routine haemodialysis patientsRia Bandiara0Astried Indrasari1Anggi Dewi Rengganis2Lilik Sukesi3Afiatin Afiatin4Prayudi Santoso5Division of Nephrology and Hypertension, Department of Internal Medicine, Faculty of Medicine, Universitas Padjadjaran/Hasan Sadikin General Hospital, Bandung, IndonesiaDivision of Nephrology and Hypertension, Department of Internal Medicine, Faculty of Medicine, Universitas Mulawarman/Abdul Wahab Sjarani Hospital, Samarinda, IndonesiaDivision of Nephrology and Hypertension, Department of Internal Medicine, Faculty of Medicine, Universitas Padjadjaran/Hasan Sadikin General Hospital, Bandung, Indonesia; Medical Faculty, Universitas Islam Bandung, Bandung, Indonesia.; Corresponding author at: Universitas Islam Bandung, Indonesia.Division of Nephrology and Hypertension, Department of Internal Medicine, Faculty of Medicine, Universitas Padjadjaran/Hasan Sadikin General Hospital, Bandung, IndonesiaDivision of Nephrology and Hypertension, Department of Internal Medicine, Faculty of Medicine, Universitas Padjadjaran/Hasan Sadikin General Hospital, Bandung, IndonesiaDivision of Pulmonology, Department of Internal Medicine, Faculty of Medicine, Universitas Padjadjaran/Hasan Sadikin General Hospital, Bandung, IndonesiaIntroduction: Since immune system alteration occurs, chronic kidney disease (CKD) on routine haemodialysis (HD) patients have a greater risk for latent tuberculosis (LTB). LTB needs special attention so that it does not develop into an active form, because infection in CKD patients increases the mortality. This study aims to determine the risk factors that associated with LTB among CKD on routine HD patients. Methods: This was a cross-sectional study conducted in Haemodialysis Unit, Hasan Sadikin General Hospital, Bandung. The subjects were recruited from March–May 2020. Subjects aged > 18 years at least have undergoing HD in 3 months and twice a week HD were included in this study. Patients with active tuberculosis (TB) suspected, malignancy, or immunocompromised were excluded. LTB was diagnosed using interferon-γ release assays (IGRA). All data including age, sex, CKD etiologies, smoking status, HD adequacy that assessed using KT/V and urea reduction ratio (URR), and contact status with TB patients were obtained and recorded in case report form. Results: A total of 120 subjects were involved. LTB based on IGRA was occurred in 39.2% subjects, while 56.7% and 4.1% subjects had negative and indeterminate IGRA, respectively. Adequacy of HD based on KT/V value was not significantly different between positive and negative IGRA subjects. Positive IGRA subjects had lower URR (p = 0.042). Smoking status had significant association with LTB (OR = 2.5[95%CI 1.2–5.4, p = 0.017). Furthermore, URR < 73% also had significant association with LTB (OR = 2.6[1.2–5.6, p = 0.013). Conclusion: Smoking status and HD adequacy based on URR < 73% are associated factors that contribute to LTB among CKD on HD patients.http://www.sciencedirect.com/science/article/pii/S2405579422000079Chronic kidney diseaseHaemodialysisLatent tuberculosisRisk factors
spellingShingle Ria Bandiara
Astried Indrasari
Anggi Dewi Rengganis
Lilik Sukesi
Afiatin Afiatin
Prayudi Santoso
Risk factors of latent tuberculosis among chronic kidney disease with routine haemodialysis patients
Journal of Clinical Tuberculosis and Other Mycobacterial Diseases
Chronic kidney disease
Haemodialysis
Latent tuberculosis
Risk factors
title Risk factors of latent tuberculosis among chronic kidney disease with routine haemodialysis patients
title_full Risk factors of latent tuberculosis among chronic kidney disease with routine haemodialysis patients
title_fullStr Risk factors of latent tuberculosis among chronic kidney disease with routine haemodialysis patients
title_full_unstemmed Risk factors of latent tuberculosis among chronic kidney disease with routine haemodialysis patients
title_short Risk factors of latent tuberculosis among chronic kidney disease with routine haemodialysis patients
title_sort risk factors of latent tuberculosis among chronic kidney disease with routine haemodialysis patients
topic Chronic kidney disease
Haemodialysis
Latent tuberculosis
Risk factors
url http://www.sciencedirect.com/science/article/pii/S2405579422000079
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