Incidence of Tuberculosis With Kidney Failure

Chronic kidney disease (CKD) is associated with a higher risk for tuberculosis after infection with Mycobacterium tuberculosis. Kimberly R. Schildknecht, MPH, and colleagues produced an estimate of tuberculosis incidence and a description of the disease among the US population with kidney failure. 

Their cross-sectional analysis began by identifying individuals in the US with a reported case of tuberculosis between 2010 and 2021. The researchers then stratified these patients by reported kidney failure status. The study’s primary outcome was tuberculosis incidence among people with kidney failure. The researchers also compared the characteristics of patients with tuberculosis by reported kidney failure status.

The researchers identified 111,155 individuals who were diagnosed with tuberculosis between 2010 and 2021; 2,892 of them (3%) also had kidney failure. The incidence of tuberculosis was 26.1 to 45.4 per 100,000 patients with kidney failure and 2.1 to 3.5 per 100,000 patients without kidney failure annually. Patients who had both tuberculosis and kidney failure were nearly twice as likely to have a false-negative tuberculin skin test result as patients with tuberculosis only (39% vs 20%).

Of the patients with kidney failure, 924 (32%) had only extrapulmonary tuberculosis. Nearly 40% of patients with kidney failure died; 286 were diagnosed with tuberculosis after death, and 792 died during treatment.

In summary, the incidence of tuberculosis among US individuals with kidney failure between 2010 and 2021 was 10 times the incidence among individuals without kidney failure.

Source: Journal of the American Society of Nephrology