Analysis of Latent Tuberculosis Risk Factors Detected by Tuberculin Skin Tests in Chronic Kidney Disease Patients Undergoing Routine Hemodialysis

Authors

  • Muhammad Andi Mardiansyah epartment of Pulmonology and Respiration Medicine, Faculty of Medicine, Universitas Syiah Kuala, dr. Zainoel Abidin Hospital, Banda Aceh
  • Yunita Arliny epartment of Pulmonology and Respiration Medicine, Faculty of Medicine, Universitas Syiah Kuala, dr. Zainoel Abidin Hospital, Banda Aceh https://orcid.org/0000-0003-1950-4025
  • Nurrahmah Yusuf epartment of Pulmonology and Respiration Medicine, Faculty of Medicine, Universitas Syiah Kuala, dr. Zainoel Abidin Hospital, Banda Aceh
  • Abdullah Abdullah epartment of Pulmonology and Respiration Medicine, Faculty of Medicine, Universitas Syiah Kuala, dr. Zainoel Abidin Hospital, Banda Aceh

DOI:

https://doi.org/10.36497/jri.v45i1.633

Keywords:

chronic kidney disease, hemodialysis, latent tuberculosis, tuberculosis, tuberculin test

Abstract

Background: Due to changes in the immune system, chronic kidney disease (CKD) patients on routine hemodialysis (HD) are at increased risk for latent tuberculosis (LTB). Latent tuberculosis requires special attention to prevent its development into active form because infection increases mortality in CKD patients. This study aims to determine the prevalence and risk factors associated with LTB in CKD in routine HD patients.

Method: This research uses a cross-sectional design and is an analytical observational study. The study was conducted in the Hemodialysis Unit at dr. Zainoel Abidin Hospital between June and August 2023, using consecutive non-probability sampling.

Results: Of the 289 CKD patients undergoing routine hemodialysis, 54 met the inclusion criteria. The prevalence of latent tuberculosis among these patients was 27.8%, as determined by the Tuberculin Skin Test (TST). Statistical analysis revealed no significant association between LTB and risk factors such as age, gender, body mass index, smoking status, or CKD etiology (P>0.05). Due to value of P>0.25, multivariate analysis could not be performed.

Conclusion: There is a high prevalence of latent tuberculosis among chronic kidney disease patients undergoing dialysis. The risk factors for LTB remain unclear. However, early diagnosis and treatment are recommended to prevent progression to active TB.

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References

1. Kementerian Kesehatan Republik Indonesia. Pedoman Nasional Pelayanan Kedokteran Tata Laksana Tuberkulosis. 2020.

2. World Health Organization. Global Tuberculosis Report 2022. Geneva; 2022.

3. Chiang LY, Baumann B, Romanowski K, et al. Latent tuberculosis therapy outcomes in dialysis patients: A retrospective cohort. American Journal of Kidney Diseases 2021;77(5):696–703.

4. Rao TM, Ram R, Swarnalatha G, et al. Tuberculosis in haemodialysis patients: A single centre experience. Indian J Nephrol 2013;23(5):340–5.

5. Kementerian Kesehatan Republik Indonesia. Petunjuk Teknis Penanganan Infeksi Laten Tuberkulosis (ILTB). 2020;1.

6. Kementerian Kesehatan Republik Indonesia. Modul 3: Diagnosis Infeksi Laten Tuberkulosis (ILTB). 2022.

7. Carranza C, Pedraza-Sanchez S, de Oyarzabal-Mendez E, et al. Diagnosis for latent tuberculosis infection: New alternatives. Front Immunol 2020;11:2006.

8. Prakash Babu S, Ezhumalai K, Raghupathy K, et al. Comparison of IGRA and TST in the diagnosis of latent tuberculosis among women of reproductive age in South India. Indian Journal of Tuberculosis 2023;70(1):12–6.

9. Brij SO, Beck SC, Kleemann F, et al. Tuberculosis screening in a dialysis unit: Detecting latent tuberculosis infection is only half the problem. Journal of Hospital Infection 2014;87(4):241–4.

10. Alemu A, Bitew ZW, Diriba G, et al. Tuberculosis incidence in patients with chronic kidney disease: A systematic review and meta-analysis. International Journal of Infectious Diseases 2022;122:188–201.

11. Ruzangi J, Iwagami M, Smeeth L, et al. The association between chronic kidney disease and tuberculosis; A comparative cohort study in England. BMC Nephrol 2020;21(1):420.

12. Chagas ACF, Hans Filho G, de Oliveira SM do VL, et al. Prevalence of latent tuberculosis and treatment adherence among patients with chronic kidney disease in Campo Grande, State of Mato Grosso do Sul. Rev Soc Bras Med Trop 2014;47(2):204–11.

13. Bandiara R, Indrasari A, Dewi Rengganis A, et al. Risk factors of latent tuberculosis among chronic kidney disease with routine haemodialysis patients. J Clin Tuberc Other Mycobact Dis 2022;27:100302.

14. Cohen G. Immune dysfunction in uremia 2020. Toxins (Basel) 2020;12(7):439.

15. Ismail MB, Zarriaa N, Osman M, et al. Prevalence of latent tuberculosis infection among patients undergoing regular hemodialysis in disenfranchised communities: A multicenter study during COVID-19 pandemic. Medicina (Lithuania) 2023;59(4).

16. Hussein MT, Yousef LM, Ali AT. Detection of latent tuberculosis infection in hemodialysis patients: Comparison between the quantiferon-tuberculosis gold test and the tuberculin skin test. Egyptian Journal of Bronchology 2017;11(3):255–9.

17. Ferreira V, Da Fonseca CD, Bollela VR, et al. Prevalence of latent tuberculosis and associated factors in patients with chronic kidney disease on hemodialysis. Rev Lat Am Enfermagem 2021;29:e3442.

18. Wu CH, Su HA, Chou CA, et al. An observational study on prevalence of latent tuberculosis infection and outcome of 3HP treatment in patients under hemodialysis in Taiwan. Journal of the Formosan Medical Association 2021;120(6):1350–60.

19. Setyawati A, Reviono R, Putranto W. The compability level of tuberculin skin test and T-SPOT.TB, sensitivity and spesifisity of T-SPOT.TB in detecting latent tuberculosis in hemodialysis patients. Jurnal Respirologi Indonesia 2021;41(1):19–27.

20. Alemu A, Bitew ZW, Diriba G, et al. The prevalence of latent tuberculosis infection in patients with chronic kidney disease: A systematic review and meta-analysis. Heliyon 2023;9(6):e17181.

21. Goweda R. Screening of latent tuberculosis infection among healthcare students and medical doctors using the tuberculin skin test. Family Medicine and Primary Care Review 2021;23(2):163–8.

22. Saag LA, LaValley MP, Hochberg NS, et al. Low body mass index and latent tuberculous infection: a systematic review and meta-analysis. Int J Tuberc Lung Dis 2018;22(4):358–365.

23. Zhang H, Li X, Xin H, et al. Association of body mass index with the tuberculosis infection: A population-based study among 17796 adults in Rural China. Sci Rep 2017;7:41933.

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Published

2025-02-07

Issue

Vol. 45 No. 1 (2025)

Section

Original Article

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Copyright (c) 2025 Muhammad Andi Mardiansyah, Yunita Arliny, Nurrahmah Yusuf, Abdullah Abdullah

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