Comparative analysis of the clinical features and prognosis of extrapulmonary tuberculosis according to the renal function.
- Author:
Bo Kyung CHOI
1
;
Hee Sun LEE
;
In Hye HWANG
;
Kyung Hwa SHIN
;
Mun Ki CHOI
;
Bo Gwang CHOI
;
Kang Hee AHN
;
Hyung Seok NAM
;
Jong Min HWANG
;
Eun Young SEOUNG
;
Sang Heon SONG
;
Soo Bong LEE
;
Ihm Soo KWAK
;
Hee Yun SEOL
Author Information
1. Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea. shsong@pusan.ac.kr
- Publication Type:Original Article
- Keywords:
Tuberculosis;
Glomerular filtration rate;
Treatment outcome
- MeSH:
Diet;
Glomerular Filtration Rate;
Humans;
Immunity, Cellular;
Kidney;
Medical Records;
Multivariate Analysis;
Pleura;
Prognosis;
Recurrence;
Renal Insufficiency, Chronic;
Retrospective Studies;
Risk Factors;
Treatment Failure;
Treatment Outcome;
Tuberculosis
- From:Korean Journal of Medicine
2010;79(4):387-393
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND/AIMS: There is an increased risk of tuberculosis (TB) with impaired cellular immunity and extrapulmonary TB is more common in patients with chronic kidney disease. We explored the clinical features and treatment outcomes of extrapulmonary TB according to renal function. METHODS: This retrospective study reviewed the medical records of patients diagnosed with extrapulmonary TB between January 2003 and December 2007. We classified the patients into two groups using the glomerular filtration rate (eGFR), estimated using the Modification of Diet in Renal Disease (MDRD) formula cut-off of 60 mL/min/1.73 m2 and evaluated their clinical features, treatment outcome and mortality (Group I vs. Group II, > or = 60 mL/min/1.73 m2). RESULTS: The mean eGFR of Groups I (n=30) and II (n=312) was 34+/-19 and 102+/-26 mL/min/1.73 m2, respectively. The pleura was the most frequent site of TB in both groups (Group I, 30.0% vs. Group II, 28.2%; p=0.379). There was no treatment failure or recurrence in either group. The mortality was higher in Group I (22.2% vs. 2.8%; p<0.01). In a multivariate analysis, eGFR<60 mL/min/1.73 m2 was an independent risk factor for mortality (HR=11.51, CI 2.512-52.741; p=0.002). CONCLUSIONS: Mortality related to extrapulmonary TB was higher in patients with impaired kidney function and kidney function was an independent predictor. However, there was no difference in treatment failure and recurrence according to renal function.
