Association of CKD with Incident Tuberculosis

• Published in: Clinical journal of the American Society of Nephrology Vol. 14; no. 7; pp. 1002 - 1010
• Main Authors: Park, Sehoon, Lee, Soojin, Kim, Yaerim, Lee, Yeonhee, Kang, Min Woo, Cho, Semin, Han, Kyungdo, Han, Seoung Seok, Lee, Hajeong, Lee, Jung Pyo, Joo, Kwon Wook, Lim, Chun Soo, Kim, Yon Su, Kim, Dong Ki
• Format: Journal Article
• Language: English
• Published: United States American Society of Nephrology 05.07.2019
• Subjects: Aged; Female; Glomerular Filtration Rate; Humans; Incidence; Male; Middle Aged; Original; Proportional Hazards Models; Renal Insufficiency, Chronic - complications; Retrospective Studies; Risk Factors; Tuberculosis - epidemiology; Tuberculosis - mortality; Body Mass Index; Renal Insufficiency, Chronic; chronic kidney disease; risk factors; Prevalence; Comorbidity; Pulmonary Disease, Chronic Obstructive; Renal Replacement Therapy; tuberculosis; diabetes mellitus; Control Groups; National Health Programs; Incidence; albuminuria; Mycobacterium tuberculosis; Epidemiology and outcomes; Retrospective Studies; hypertension; renal dialysis; Smoking
• ISSN: 1555-9041; 1555-905X
• DOI: 10.2215/CJN.14471218

The incidence and risk of in people with predialysis CKD has rarely been studied, although CKD prevalence is increasing in certain countries where is endemic. We aimed to investigate the association between predialysis CKD and active risks in a nation with moderate risk. In this nationwide retrospective cohort study, we reviewed the National Health Insurance Database of Korea, screening 17,020,339 people who received a national health screening two or more times from 2012 to 2016. Predialysis CKD was identified with consecutive laboratory results indicative of CKD ( , persistent eGFR <60 ml/min per 1.73 m or dipstick albuminuria). People with preexisting active or kidney replacement therapy were excluded. A 1:1 matched control group without CKD was included with matching for age, sex, low-income status, and smoking history. The risk of incident active , identified in the claims database, was assessed by the multivariable Cox regression model, which included both matched and unmatched variables ( , body mass index, diabetes, hypertension, places of residence, and other comorbidities). We included 408,873 people with predialysis CKD and the same number of controls. We identified 1704 patients with active (incidence rate =137.5/100,000 person-years) in the predialysis CKD group and 1518 patients with active (incidence rate =121.9/100,000 person-years) in the matched controls. The active risk was significantly higher in the predialysis CKD group (adjusted hazard ratio, 1.21; 95% confidence interval, 1.13 to 1.30). The risk factors for active among the predialysis CKD group were old age, men, current smoking, low income, underlying diabetes, chronic obstructive pulmonary disease, and Kidney Disease Improving Global Outcomes CKD stage 1 (eGFR≥90 ml/min per 1.73 m with persistent albuminuria) or stage 4/5 without dialysis (eGFR<30 ml/min per 1.73 m ). In the Korean population, the incidence of active was higher in people with versus without predialysis CKD.