The Prevalence and Risk Factors for Latent Mycobacterium Tuberculosis Infection in Patients with Chronic Kidney Disease

Introduction and Objective.Active tuberculosis (TB), which develops mostly in the mechanism of latent tuberculosis infection (LTBI) activation, is a difficult and important problem among patients with chronic kidney disease (CKD).The aim of the study was to determine the prevalence of LTBI and associated risk factors in CKD patients, both undergoing dialysis and in the pre-dialysis stage.Materials and method.The study comprised 482 subjects aged 19-98, including 294 haemodialysis, 50 peritoneal dialysis and 32 pre-dialysis patients, as well as 106 healthy controls.In order to determine LTBI, QuantiFERON Gold In-Tube Test (QFT-GIT, Cellestis Ltd, Australia) was used.Results.Positive QFT-GIT test was obtained in 32% haemodialysis, 28.1% pre-dialysis, 12% peritoneal dialysis patients, and in 11.3% controls.By univariate logistic regression analysis, predictors of LTBI were: active smoking (OR=1.34),coronary artery disease (OR=1.32),age (OR=1.04),male gender (OR=1.42),platelet count (OR=1.00),and duration of dialysis (OR=.95).By multivariate logistic regression, independent predictors of LTBI were: age (OR=1.02),male (OR=1.81),haemodialysis procedure (OR=2.39),TB contact (OR=2.46)and platelet count (OR=.99).Conclusions.The obtained results revealed a high prevalence of LTBI in CKD patients.Established risk factors, especially those described for the first time, such as platelet count and coronary artery disease, provided clinical support in TB diagnosis.Since a high LTBI rate in CKD patients was observed, wide use of the QFT-GIT test is recommend to control TB in this population.