Risk of tuberculosis in dialysis patients: a nationwide cohort study
The ability to identify individuals at increased risk of developing tuberculosis (TB) has important implications for public health policy and patient care. We conducted a general population historical cohort study in all Australian States and Territories to establish the risk of TB arising in people...
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| Veröffentlicht in: | PloS one 2011-12, Vol.6 (12), p.e29563 |
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| description | The ability to identify individuals at increased risk of developing tuberculosis (TB) has important implications for public health policy and patient care. We conducted a general population historical cohort study in all Australian States and Territories to establish the risk of TB arising in people on chronic hemo- or peritoneal dialysis.
Cases of TB disease in patients receiving chronic dialysis were identified by record linkage using the Australia & New Zealand Dialysis and Transplant Registry (ANZDATA) and State and Territory TB notification databases 2001 to 2006. Main outcome measure was the relative risk of TB in people on dialysis, adjusted for TB incidence in country of birth, sex, age and indigenous status. A total of 6,276 cases of active TB were reported among 19,855,283 people living in Australia between 2001 and 2006. Among 14,506 patients on dialysis, 37 had a notification for TB disease after commencing dialysis, of whom 28 were culture positive. The incidence of TB was 66.8/100,000/year (95% CI 47.7 to 93.2) among people on dialysis and 5.7/100,000/year (95% CI 5.5 to 5.8) in the general population. The adjusted relative risk (aRR) of TB in people on dialysis was 7.8 (95% CI 3.3 to 18.7), and the aRR of culture positive TB was 8.6 (95% CI 3.9 to 19.3).
Patients on dialysis are at increased risk of TB. The final decision to screen for, and to treat, LTBI in individual dialysis patients will be influenced by a cumulative assessment of the risk of reactivation of TB and by assessment of risk factors for adverse effects of treatment. |
| doi_str_mv | 10.1371/journal.pone.0029563 |
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Cases of TB disease in patients receiving chronic dialysis were identified by record linkage using the Australia & New Zealand Dialysis and Transplant Registry (ANZDATA) and State and Territory TB notification databases 2001 to 2006. Main outcome measure was the relative risk of TB in people on dialysis, adjusted for TB incidence in country of birth, sex, age and indigenous status. A total of 6,276 cases of active TB were reported among 19,855,283 people living in Australia between 2001 and 2006. Among 14,506 patients on dialysis, 37 had a notification for TB disease after commencing dialysis, of whom 28 were culture positive. The incidence of TB was 66.8/100,000/year (95% CI 47.7 to 93.2) among people on dialysis and 5.7/100,000/year (95% CI 5.5 to 5.8) in the general population. The adjusted relative risk (aRR) of TB in people on dialysis was 7.8 (95% CI 3.3 to 18.7), and the aRR of culture positive TB was 8.6 (95% CI 3.9 to 19.3).
Patients on dialysis are at increased risk of TB. The final decision to screen for, and to treat, LTBI in individual dialysis patients will be influenced by a cumulative assessment of the risk of reactivation of TB and by assessment of risk factors for adverse effects of treatment.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0029563</identifier><identifier>PMID: 22216316</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Acquired immune deficiency syndrome ; Activation ; Adolescent ; Adult ; Aged ; Aged, 80 and over ; AIDS ; Australia - epidemiology ; Biology ; Cohort analysis ; Cohort Studies ; Development and progression ; Dialysis ; Epidemiology ; Health policy ; Health risk assessment ; Humans ; Incidence ; Medical Record Linkage ; Medical research ; Medicine ; Middle Aged ; New Zealand - epidemiology ; Patient care ; Patients ; Peritoneal dialysis ; Peritoneum ; Population studies ; Public health ; Registries ; Renal Replacement Therapy - adverse effects ; Risk analysis ; Risk assessment ; Risk factors ; Studies ; Territory ; Tuberculosis ; Tuberculosis - epidemiology ; Young Adult</subject><ispartof>PloS one, 2011-12, Vol.6 (12), p.e29563</ispartof><rights>2011 Dobler et al.</rights><rights>COPYRIGHT 2011 Public Library of Science</rights><rights>2011 Dobler et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License: https://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>Dobler et al. 2011</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c786t-30d437c1206fb764233ee1a7f55dfb9578cfc29497ba60df1e94669eaf035cbd3</citedby><cites>FETCH-LOGICAL-c786t-30d437c1206fb764233ee1a7f55dfb9578cfc29497ba60df1e94669eaf035cbd3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC3246480/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC3246480/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,860,881,2096,2915,23845,27901,27902,53766,53768,79342,79343</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/22216316$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Dobler, Claudia C</creatorcontrib><creatorcontrib>McDonald, Stephen P</creatorcontrib><creatorcontrib>Marks, Guy B</creatorcontrib><title>Risk of tuberculosis in dialysis patients: a nationwide cohort study</title><title>PloS one</title><addtitle>PLoS One</addtitle><description>The ability to identify individuals at increased risk of developing tuberculosis (TB) has important implications for public health policy and patient care. We conducted a general population historical cohort study in all Australian States and Territories to establish the risk of TB arising in people on chronic hemo- or peritoneal dialysis.
Cases of TB disease in patients receiving chronic dialysis were identified by record linkage using the Australia & New Zealand Dialysis and Transplant Registry (ANZDATA) and State and Territory TB notification databases 2001 to 2006. Main outcome measure was the relative risk of TB in people on dialysis, adjusted for TB incidence in country of birth, sex, age and indigenous status. A total of 6,276 cases of active TB were reported among 19,855,283 people living in Australia between 2001 and 2006. Among 14,506 patients on dialysis, 37 had a notification for TB disease after commencing dialysis, of whom 28 were culture positive. The incidence of TB was 66.8/100,000/year (95% CI 47.7 to 93.2) among people on dialysis and 5.7/100,000/year (95% CI 5.5 to 5.8) in the general population. The adjusted relative risk (aRR) of TB in people on dialysis was 7.8 (95% CI 3.3 to 18.7), and the aRR of culture positive TB was 8.6 (95% CI 3.9 to 19.3).
Patients on dialysis are at increased risk of TB. The final decision to screen for, and to treat, LTBI in individual dialysis patients will be influenced by a cumulative assessment of the risk of reactivation of TB and by assessment of risk factors for adverse effects of treatment.</description><subject>Acquired immune deficiency syndrome</subject><subject>Activation</subject><subject>Adolescent</subject><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>AIDS</subject><subject>Australia - epidemiology</subject><subject>Biology</subject><subject>Cohort analysis</subject><subject>Cohort Studies</subject><subject>Development and progression</subject><subject>Dialysis</subject><subject>Epidemiology</subject><subject>Health policy</subject><subject>Health risk assessment</subject><subject>Humans</subject><subject>Incidence</subject><subject>Medical Record Linkage</subject><subject>Medical research</subject><subject>Medicine</subject><subject>Middle Aged</subject><subject>New Zealand - epidemiology</subject><subject>Patient care</subject><subject>Patients</subject><subject>Peritoneal dialysis</subject><subject>Peritoneum</subject><subject>Population studies</subject><subject>Public health</subject><subject>Registries</subject><subject>Renal Replacement Therapy - adverse effects</subject><subject>Risk analysis</subject><subject>Risk assessment</subject><subject>Risk factors</subject><subject>Studies</subject><subject>Territory</subject><subject>Tuberculosis</subject><subject>Tuberculosis - epidemiology</subject><subject>Young Adult</subject><issn>1932-6203</issn><issn>1932-6203</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2011</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><sourceid>DOA</sourceid><recordid>eNqNktuLEzEUxgdR3HX1PxAdEAQfWnObTLIPwrLeCgsL6-U15NqmTic1yaj9703t7NIBBclDDie_8-Xw8VXVUwjmELfw9ToMsZfdfBt6OwcA8Ybie9Up5BjNKAL4_lF9Uj1KaQ1AgxmlD6sThBCkGNLT6u2NT9_q4Oo8KBv10IXkU-372njZ7fb1VmZv-5zOa1n3pQ79T29srcMqxFynPJjd4-qBk12yT8b7rPry_t3ny4-zq-sPi8uLq5luGc0zDAzBrYYIUKdaShDG1kLZuqYxTvGmZdppxAlvlaTAOGg5oZRb6QButDL4rHp-0N2WNcVoQBIQQwg5ZwgVYnEgTJBrsY1-I-NOBOnFn0aISyFj9rqzQjXQEMY1UxgS1FIGmaIUtUBpTSUGRevN-NugNtboYkKU3UR0-tL7lViGHwIjQgnbC7wYBWL4PtiU_7HySC1l2cr3LhQxvfFJiwtS1moYxLRQ879Q5Ri78bpEwPnSnwy8mgwUJttfeSmHlMTi083_s9dfp-zLI3ZlZZdXKXTDPhhpCpIDqGNIKVp35xwEYp_gWzfEPsFiTHAZe3bs-t3QbWTxb_hO6sc</recordid><startdate>20111227</startdate><enddate>20111227</enddate><creator>Dobler, Claudia C</creator><creator>McDonald, Stephen P</creator><creator>Marks, Guy B</creator><general>Public Library of Science</general><general>Public Library of Science (PLoS)</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>IOV</scope><scope>ISR</scope><scope>3V.</scope><scope>7QG</scope><scope>7QL</scope><scope>7QO</scope><scope>7RV</scope><scope>7SN</scope><scope>7SS</scope><scope>7T5</scope><scope>7TG</scope><scope>7TM</scope><scope>7U9</scope><scope>7X2</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FD</scope><scope>8FE</scope><scope>8FG</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABJCF</scope><scope>ABUWG</scope><scope>AEUYN</scope><scope>AFKRA</scope><scope>ARAPS</scope><scope>ATCPS</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BGLVJ</scope><scope>BHPHI</scope><scope>C1K</scope><scope>CCPQU</scope><scope>D1I</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>H94</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>KB.</scope><scope>KB0</scope><scope>KL.</scope><scope>L6V</scope><scope>LK8</scope><scope>M0K</scope><scope>M0S</scope><scope>M1P</scope><scope>M7N</scope><scope>M7P</scope><scope>M7S</scope><scope>NAPCQ</scope><scope>P5Z</scope><scope>P62</scope><scope>P64</scope><scope>PATMY</scope><scope>PDBOC</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>PTHSS</scope><scope>PYCSY</scope><scope>RC3</scope><scope>5PM</scope><scope>DOA</scope></search><sort><creationdate>20111227</creationdate><title>Risk of tuberculosis in dialysis patients: a nationwide cohort study</title><author>Dobler, Claudia C ; McDonald, Stephen P ; Marks, Guy B</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c786t-30d437c1206fb764233ee1a7f55dfb9578cfc29497ba60df1e94669eaf035cbd3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2011</creationdate><topic>Acquired immune deficiency syndrome</topic><topic>Activation</topic><topic>Adolescent</topic><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>AIDS</topic><topic>Australia - epidemiology</topic><topic>Biology</topic><topic>Cohort analysis</topic><topic>Cohort Studies</topic><topic>Development and progression</topic><topic>Dialysis</topic><topic>Epidemiology</topic><topic>Health policy</topic><topic>Health risk assessment</topic><topic>Humans</topic><topic>Incidence</topic><topic>Medical Record Linkage</topic><topic>Medical research</topic><topic>Medicine</topic><topic>Middle Aged</topic><topic>New Zealand - epidemiology</topic><topic>Patient care</topic><topic>Patients</topic><topic>Peritoneal dialysis</topic><topic>Peritoneum</topic><topic>Population studies</topic><topic>Public health</topic><topic>Registries</topic><topic>Renal Replacement Therapy - adverse effects</topic><topic>Risk analysis</topic><topic>Risk assessment</topic><topic>Risk factors</topic><topic>Studies</topic><topic>Territory</topic><topic>Tuberculosis</topic><topic>Tuberculosis - epidemiology</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Dobler, Claudia C</creatorcontrib><creatorcontrib>McDonald, Stephen P</creatorcontrib><creatorcontrib>Marks, Guy B</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Gale In Context: Opposing Viewpoints</collection><collection>Gale In Context: Science</collection><collection>ProQuest Central (Corporate)</collection><collection>Animal Behavior Abstracts</collection><collection>Bacteriology Abstracts (Microbiology B)</collection><collection>Biotechnology Research Abstracts</collection><collection>Nursing & Allied Health Database</collection><collection>Ecology Abstracts</collection><collection>Entomology Abstracts (Full archive)</collection><collection>Immunology Abstracts</collection><collection>Meteorological & Geoastrophysical Abstracts</collection><collection>Nucleic Acids Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>Agricultural Science Collection</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Public Health Database</collection><collection>Technology Research Database</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Technology Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Materials Science & Engineering Collection</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest One Sustainability</collection><collection>ProQuest Central UK/Ireland</collection><collection>Advanced Technologies & Aerospace Collection</collection><collection>Agricultural & Environmental Science Collection</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>ProQuest Central</collection><collection>Technology Collection</collection><collection>Natural Science Collection</collection><collection>Environmental Sciences and Pollution Management</collection><collection>ProQuest One Community College</collection><collection>ProQuest Materials Science Collection</collection><collection>ProQuest Central Korea</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Materials Science Database</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Meteorological & Geoastrophysical Abstracts - 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We conducted a general population historical cohort study in all Australian States and Territories to establish the risk of TB arising in people on chronic hemo- or peritoneal dialysis.
Cases of TB disease in patients receiving chronic dialysis were identified by record linkage using the Australia & New Zealand Dialysis and Transplant Registry (ANZDATA) and State and Territory TB notification databases 2001 to 2006. Main outcome measure was the relative risk of TB in people on dialysis, adjusted for TB incidence in country of birth, sex, age and indigenous status. A total of 6,276 cases of active TB were reported among 19,855,283 people living in Australia between 2001 and 2006. Among 14,506 patients on dialysis, 37 had a notification for TB disease after commencing dialysis, of whom 28 were culture positive. The incidence of TB was 66.8/100,000/year (95% CI 47.7 to 93.2) among people on dialysis and 5.7/100,000/year (95% CI 5.5 to 5.8) in the general population. The adjusted relative risk (aRR) of TB in people on dialysis was 7.8 (95% CI 3.3 to 18.7), and the aRR of culture positive TB was 8.6 (95% CI 3.9 to 19.3).
Patients on dialysis are at increased risk of TB. The final decision to screen for, and to treat, LTBI in individual dialysis patients will be influenced by a cumulative assessment of the risk of reactivation of TB and by assessment of risk factors for adverse effects of treatment.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>22216316</pmid><doi>10.1371/journal.pone.0029563</doi><tpages>e29563</tpages><oa>free_for_read</oa></addata></record> |
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| source | MEDLINE; DOAJ Directory of Open Access Journals; EZB-FREE-00999 freely available EZB journals; PubMed Central; Free Full-Text Journals in Chemistry; Public Library of Science (PLoS) |
| subjects | Acquired immune deficiency syndrome Activation Adolescent Adult Aged Aged, 80 and over AIDS Australia - epidemiology Biology Cohort analysis Cohort Studies Development and progression Dialysis Epidemiology Health policy Health risk assessment Humans Incidence Medical Record Linkage Medical research Medicine Middle Aged New Zealand - epidemiology Patient care Patients Peritoneal dialysis Peritoneum Population studies Public health Registries Renal Replacement Therapy - adverse effects Risk analysis Risk assessment Risk factors Studies Territory Tuberculosis Tuberculosis - epidemiology Young Adult |
| title | Risk of tuberculosis in dialysis patients: a nationwide cohort study |
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