Increased risk of tuberculosis in patients with end-stage renal disease: a population-based cohort study in Taiwan, a country of high incidence of end-stage renal disease
Increased risk of tuberculosis in patients with end-stage renal disease: a population-based cohort study in Taiwan, a country of high incidence of end-stage renal disease
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DOI：
10.1017/s0950268813000551
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发表时间：
2014-01-01
影响因子：
4.2
通讯作者：
Chu, D.
中科院分区：
文献类型：
--
作者：
Hu, H. Y.;Wu, C. Y.;Chu, D.
这项全国范围的人群队列研究调查了终末期肾病（ESRD）患者接受透析的结核病（TB）风险。评估包括4131例接受透析的ESRD患者和16524例年龄和性别匹配的对照，招募于1998年至2009年。我们使用考克斯比例风险回归分析来衡量结核病和终末期肾病之间的关联。与对照组相比，ESRD队列在发生ESRD后1年内[发病率比（IRR）413]和1-2年内（IRR 212）的TB风险显著更高。考克斯比例风险模型显示，终末期肾病[风险比（HR）240]、年龄>65岁（HR 241）、男性（HR 194）、糖尿病（HR 136）、矽肺（HR 770）和慢性阻塞性肺疾病（HR 161）是TB的独立危险因素。终末期肾病患者与结核病风险增加相关，因此应更仔细地监测结核病，特别是在终末期肾病发作后2年内。
This nationwide population-based cohort study investigated the risk of tuberculosis (TB) in patients with end-stage renal disease (ESRD) and receiving dialysis. The evaluations included 4131 incident ESRD patients receiving dialysis and 16524 age- and gender-matched controls, recruited between 1998 and 2009. We used Cox proportional hazards regression analysis to measure the association between TB and ESRD. Compared to the controls, the ESRD cohort had a significantly higher risk of TB within 1 year [incident rate ratio (IRR) 413], and 1-2 years (IRR 212), of occurrence of ESRD. The Cox proportional hazards model revealed that ESRD [hazard ratio (HR) 240], age >65 years (HR 241), male sex (HR 194), diabetes mellitus (HR 136), silicosis (HR 770) and chronic obstructive pulmonary disease (HR 161) are independent risk factors for TB. Patients with ESRD are associated with an increased risk of TB, and should thus be monitored more carefully for TB, especially within 2 years of onset of ESRD.