Prognosis of patients diagnosed with latent tuberculosis infection at dialysis initiation.

IF 2.2 4区医学 Q2 UROLOGY & NEPHROLOGY

Clinical and Experimental Nephrology Pub Date : 2025-04-04 DOI:10.1007/s10157-025-02667-y

Mea Aso, Kaori Kohatsu, Suguru Takayama, Takuya Matsuda, Shigeki Kojima, Yugo Shibagaki, Tsutomu Sakurada

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引用次数: 0

Abstract

Background: The prognosis of Japanese dialysis patients diagnosed with latent tuberculosis infection (LTBI) at the time of starting dialysis remains unclear. The purpose of this study was to examine whether there is a difference in prognosis between incident dialysis patients with and without LTBI.

Methods: A retrospective study of incident dialysis patients who underwent an interferon-gamma release assay (T-SPOT test) within 1 year before or after dialysis initiation at our hospital between May 1, 2013, and December 31, 2021 was conducted. Using propensity score matching (PSM), survival of the non-LTBI and LTBI groups was compared after adjusting for patient background characteristics.

Results: Of the 737 incident dialysis patients, 276 (37.4%) underwent the T-SPOT test, of whom 23 (8.3%) were diagnosed with LTBI. After matching for age, sex, activities of daily living (ADL), estimated glomerular filtration rate (eGFR), Charlson comorbidity index (CCI), and serum albumin level, 23 patients were selected for each group. Kaplan-Meier analysis showed a significantly lower cumulative survival rate in the LTBI group (p = 0.048, log-rank test). In the LTBI group, the cumulative survival rate tended to be higher in the LTBI-treated group (n = 13) than in the untreated group (n = 10) (p = 0.089).

Conclusion: Patients with LTBI at dialysis initiation have a poorer prognosis than those without LTBI, and LTBI treatment may improve their prognosis. This study emphasizes the clinical importance and necessity of managing LTBI in dialysis patients.

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透析开始时诊断为潜伏结核感染患者的预后。

背景：日本透析患者在开始透析时诊断为潜伏性结核感染（LTBI）的预后尚不清楚。本研究的目的是探讨合并和不合并LTBI的透析患者预后是否存在差异。方法：回顾性研究2013年5月1日至2021年12月31日在我院开始透析前后1年内接受干扰素γ释放试验（T-SPOT试验）的偶发透析患者。采用倾向评分匹配（PSM），在调整患者背景特征后，比较非LTBI组和LTBI组的生存率。结果：在737例透析患者中，276例（37.4%）接受了T-SPOT测试，其中23例（8.3%）被诊断为LTBI。将年龄、性别、日常生活活动（ADL）、估计肾小球滤过率（eGFR）、Charlson合并症指数（CCI）、血清白蛋白水平进行匹配后，每组各选择23例患者。Kaplan-Meier分析显示，LTBI组的累积生存率显著降低（p = 0.048， log-rank检验）。在LTBI组中，LTBI治疗组（n = 13）的累积生存率往往高于未治疗组（n = 10）（p = 0.089）。结论：透析开始时发生LTBI的患者预后较无LTBI的患者差，LTBI治疗可改善其预后。本研究强调了处理透析患者LTBI的临床重要性和必要性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical and Experimental Nephrology UROLOGY & NEPHROLOGY-

CiteScore

4.10

自引率

4.30%

发文量

135

审稿时长

4-8 weeks

期刊介绍： Clinical and Experimental Nephrology is a peer-reviewed monthly journal, officially published by the Japanese Society of Nephrology (JSN) to provide an international forum for the discussion of research and issues relating to the study of nephrology. Out of respect for the founders of the JSN, the title of this journal uses the term “nephrology,” a word created and brought into use with the establishment of the JSN (Japanese Journal of Nephrology, Vol. 2, No. 1, 1960). The journal publishes articles on all aspects of nephrology, including basic, experimental, and clinical research, so as to share the latest research findings and ideas not only with members of the JSN, but with all researchers who wish to contribute to a better understanding of recent advances in nephrology. The journal is unique in that it introduces to an international readership original reports from Japan and also the clinical standards discussed and agreed by JSN.