Risk of tuberculosis among patients on dialysis

Shu, C.C., Hsu, C.L., Wei, Y.F., Lee, C.Y., Liou, H.H., Wu, V.C., Yang, F.J., Lin, H.H., Wang, J.Y., Chen, J.S. and Yu, C.J., 2016. Risk of tuberculosis among patients on dialysis: the predictive value of serial interferon-gamma release assay. Medicine, 95(22), p.e3813.


Epidemiology and Diagnostics:

  • Tuberculosis (TB) incidence was reported at 319.1 per 100,000 persons.
  • QuantiFERON-TB Gold In-Tube (QFT-GIT) test had no predictive role for TB.

Risk Factors for TB in Dialysis Patients:

  • Factors such as current smoking, brief dialysis duration, active radiographic lesions, and fever were linked with prevalent TB.
  • Reasons for increased TB risk in individuals with renal failure include enhanced immune cell apoptosis, lymphocyte depletion, and dysfunction of polymorphonuclear leukocytes, all exacerbated by oxidative stress and uremic toxins from the blood.

TB Risk and Management in the Dialysis Population:

  • The dialysis population has a high TB risk; a positive QFT-GIT test indicates a high TB risk despite a 49.6% rate of negative conversion.
  • Persistent positivity in QFT-GIT testing is associated with higher hazard ratio (HR) and specificity for future TB development.

 

Comments

Post a Comment

Popular posts from this blog

Nutritional status in patients with TB and DM

Patel, D.G., Baral, T., Kurian, S.J., Malakapogu, P., Saravu, K. and Miraj, S.S., 2024. Nutritional status in patients with tuberculosis and diabetes mellitus: A comparative observational study.  Journal of Clinical Tuberculosis and Other Mycobacterial Diseases ,  35 , p.100428. Cardiovascular disease prevalence was highest in the DM group, followed by the TB-DM group. Anaemia was more prevalent in the TB-DM group. Smoking and alcohol use were most common in the TB group, followed by the TB-DM group. See also: TB and kidney function impairment In the TB-DM group, HbA1c levels indicated poor diabetic control (10.47%), higher than in the DM group (8.17%). FBS was also above normal in the TB-DM group, followed by the DM group. Although there were no significant differences in nutritional parameters like albumin, globulin, and total proteins, vitamin B12 levels were highest in the TB-DM group. Notably, 95.83% of patients in the TB-DM group had HbA1c > 6.5, with similarly high FBS and RB
Read more

Scientific advances and the end of tuberculosis

Reid, M., Agbassi, Y.J.P., Arinaminpathy, N., Bercasio, A., Bhargava, A., Bhargava, M., Bloom, A., Cattamanchi, A., Chaisson, R., Chin, D. and Churchyard, G., 2023. Scientific advances and the end of tuberculosis: a report from the Lancet Commission on Tuberculosis.  The Lancet ,  402 (10411), pp.1473-1498. Progress toward ending tuberculosis varies greatly across countries, with some achieving substantial improvements and others making minimal progress. Key challenges include frail health systems, underinvestment, and reliance on one-size-fits-all approaches. Insufficient case finding and diagnosis remain the most significant issues in high-burden countries, where only 38% of all tuberculosis cases were tested with WHO-recommended rapid molecular diagnostics in 2021. Two-thirds of tuberculosis deaths occurred in just eight countries, with over half of these in India, Indonesia, and Nigeria. Despite these challenges, some sub-Saharan African countries have seen improvements in tubercul
Read more

Impact of diabetes on tuberculosis and MDRTB susceptibility

There is a significant association between diabetes mellitus (DM) and multidrug-resistant tuberculosis (MDR-TB). TB patients without DM have a lower risk of developing MDR-TB compared to those with DM. Factors contributing to MDR-TB emergence in TB patients with DM include: Impaired immune function Altered microbial genomics Uncontrolled glucose levels, increasing susceptibility to MDR-TB Compromised phagocytic activity and reduced chemotactic response Increased oxidative species and microbe proliferation Altered drug disposition Higher likelihood of non-adherence to treatment TB patients with DM also experience higher treatment failure rates compared to those without DM. Most information on these associations is based on self-reported data or patient health records, which may introduce assessment errors Rehman Au, Khattak M, Mushtaq U, Latif M, Ahmad I, Rasool MF, Shakeel S, Hayat K, Hussain R, Alhazmi GA, Alshomrani AO, Alalawi MI, Alghamdi S, Imam MT, Almarzoky Abuhussain SS, Khayya
Read more