239760 High Risk of Pulmonary Tuberculosis Infection in Patients with Chronic Renal Failure: A Population-Based Cohort Study

Tuesday, November 1, 2011: 3:20 PM

Hsiao-Yun Hu , Institute of Public Health & Department of Public Health, National Yang-Ming University, Taipei, Taiwan
Chen-Yi Wu , Division of Dermatology, Taipei County Hospital, Taipe, Taiwan
Nicole Huang , Institute of Hospital and Health Care Administration, National Yang Ming University, Taipei, Taiwan
Yiing-Jenq Chou, MD, PhD , Institute of Public Health, National Yang-Ming University, Taipei, Taiwan
Dachen Chu , Institute of Public Health & Department of Public Health, National Yang Ming University, Taipei, Taiwan
     
Background: Individuals with chronic renal failure and dialysis suffer impaired cellular immunity and have an increased risk of pulmonary tuberculosis infection, but the magnitude remains unclear. The purpose of this study was to perform a nationwide population-based cohort study to investigate the risk of pulmonary TB infection in patients with chronic renal failure. Methods: This nationwide population-based cohort study was based on data obtained from the Taiwan National Health Insurance Database. In total, 4,156 incident cases of chronic renal failure patients and 16,624 controls matched on age and gender were recruited for the study from 1998 to 2009. Results: The incidence rate (IR) of pulmonary TB (286 of 100,000 person-years) was significantly higher in the chronic renal failure patients than that in controls (109 of 100,000 person-years) (incidence rate ratio [IRR]: 2.63; 95% confidence interval [CI]: 1.87-3.64). Compared with the controls, the IRRs of pulmonary TB in the chronic renal failure cohort were 1.10 at 1-2 years, 1.50 at 3-4 years, 2.04 at 5-8 years, and 6.96 at 9-12 years after chronic renal failure. The multivariate Cox proportional hazards model revealed that chronic renal failure (hazard ratio [HR]: 1.69, 95% CI: 1.22-2.34) and chronic obstructive pulmonary disease (HR: 2.40, 95% CI: 1.79-3.22) are independent risk factors for pulmonary TB infections. Conclusion: Patients with chronic renal failure is associated with an increased risk of pulmonary infection with TB.

Learning Areas:
Chronic disease management and prevention
Epidemiology
Provision of health care to the public

Learning Objectives:
To evaluate the association between chronic renal failure and subsequent risk of pulmonary TB from a national health insurance program claim data.

Keywords: Chronic Diseases, Tuberculosis

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am qualified to present because I oversee all aspects of this study including conceptualization, analyses, interpretations, and writing of the article.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

See more of: Chronic Disease Epidemiology
See more of: Epidemiology