{"title":"透析开始时诊断为潜伏结核感染患者的预后。","authors":"Mea Aso, Kaori Kohatsu, Suguru Takayama, Takuya Matsuda, Shigeki Kojima, Yugo Shibagaki, Tsutomu Sakurada","doi":"10.1007/s10157-025-02667-y","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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).</p><p><strong>Conclusion: </strong>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.</p>","PeriodicalId":10349,"journal":{"name":"Clinical and Experimental Nephrology","volume":" ","pages":""},"PeriodicalIF":2.2000,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Prognosis of patients diagnosed with latent tuberculosis infection at dialysis initiation.\",\"authors\":\"Mea Aso, Kaori Kohatsu, Suguru Takayama, Takuya Matsuda, Shigeki Kojima, Yugo Shibagaki, Tsutomu Sakurada\",\"doi\":\"10.1007/s10157-025-02667-y\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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).</p><p><strong>Conclusion: </strong>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.</p>\",\"PeriodicalId\":10349,\"journal\":{\"name\":\"Clinical and Experimental Nephrology\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":2.2000,\"publicationDate\":\"2025-04-04\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Clinical and Experimental Nephrology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1007/s10157-025-02667-y\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"UROLOGY & NEPHROLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Clinical and Experimental Nephrology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s10157-025-02667-y","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"UROLOGY & NEPHROLOGY","Score":null,"Total":0}
Prognosis of patients diagnosed with latent tuberculosis infection at dialysis initiation.
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.
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.
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