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Risk of active tuberculosis infection in kidney transplantation recipients: A matched comparative nationwide cohort study |
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| Authors: | Sehoon Park Sanghyun Park Ji Eun Kim Mi-Yeon Yu Yong Chul Kim Dong Ki Kim Kwon Wook Joo Yon Su Kim Kyungdo Han Hajeong Lee |
| Affiliation: | 1. Department of Biomedical Sciences, Seoul National University College of Medicine, Seoul, Korea;2. Department of Medical Statistics, College of Medicine, Catholic University of Korea, Seoul, Korea;3. Department of Internal Medicine, Korea University Guro Hospital, Seoul, Korea;4. Department of Internal Medicine, Hanyang University Guri Hospital, Gyeonggi-do, Korea;5. Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea;6. Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea Kidney Research Institute, Seoul National University, Seoul, Korea;7. Department of Biomedical Sciences, Seoul National University College of Medicine, Seoul, Korea Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea Kidney Research Institute, Seoul National University, Seoul, Korea;8. Department of Statistics and Actuarial Science, Soongsil University, Seoul, Korea |
| Abstract: | Large-scale evidence comparing the risk of Mycobacterium tuberculosis (TB) between kidney transplant (KT) recipients and dialysis patients is warranted. This is a nationwide retrospective cohort study based on the claims database of South Korea where a moderate prevalence of TB is reported. We included incident KT recipients from 2011 to 2015 and compared their active TB risks with 1:1 matched dialysis and general population control groups, respectively. The risk of incident active TB was assessed by multivariable Cox regression. Associations between active TB and posttransplant death or death-censored graft failure were investigated. The number of matched subjects included in each of the study groups was 7462. The KT group showed a significantly higher risk of active TB than the general population group (hazard ratio [HR] 3.39 [1.88–6.10]), whereas it showed a similar risk to that of the dialysis group (HR 0.98 [0.73–1.31]). In KT patients, active TB was a significant risk factor for both death (HR 2.33 [1.24–4.39]) and death-censored graft failure (HR 2.26 [1.39–3.67]). Although KT recipients may not have to burden the additional risk of active TB when compared with dialysis patients in recent medicine, active TB should not be overlooked as it is associated with a worse prognosis in posttransplant patients. |
| Keywords: | clinical research/practice infection-mycobacterial infectious disease kidney failure/injury kidney transplantation/nephrology |