Korean J Med.  2010 Oct;79(4):387-393.

Comparative analysis of the clinical features and prognosis of extrapulmonary tuberculosis according to the renal function

• Choi BK
• Lee HS
• Hwang IH
• Shin KH
• Choi MK
• Choi BG
• Ahn KH
• Nam HS
• Hwang JM
• Seoung EY
• Song SH
• Lee SB
• Kwak IS
• Seol HY

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.

Keyword

Tuberculosis; Glomerular filtration rate; Treatment outcome

MeSH Terms

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