Epidemiology of tuberculosis after kidney transplantation in a developing country
Background Tuberculosis (TB) is a great challenge in kidney transplantation, and is often associated with high morbidity and mortality. The aim of this study was to evaluate the epidemiology, clinical manifestations, and impact of TB in kidney transplant (KT) recipients. Methods We performed a retro...
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| Veröffentlicht in: | Transplant infectious disease 2016-04, Vol.18 (2), p.176-182 |
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| creator | Meinerz, G. da Silva, C.K. Goldani, J.C. Garcia, V.D. Keitel, E. |
| description | Background
Tuberculosis (TB) is a great challenge in kidney transplantation, and is often associated with high morbidity and mortality. The aim of this study was to evaluate the epidemiology, clinical manifestations, and impact of TB in kidney transplant (KT) recipients.
Methods
We performed a retrospective analysis of a cohort of adult KT recipients from 2000 to 2012, with follow‐up until July 2014.
Results
Among the 1737 KT recipients evaluated, 60 developed TB: a 5% cumulative incidence, and an incidence rate of 589.4 cases/100,000 patient‐years. Median time to diagnosis was 13.4 months, with 40% of the cases occurring in the first year. New‐onset diabetes was significantly associated with post‐transplant TB (P = 0.018). Pulmonary TB represented 78% of the cases, including disseminated disease. Two patients received latent TB treatment and developed active infection. TB was associated with a significant reduction in patient and graft survival (74% vs. 90.2% in 5 years for patient survival, P = 0.001; and 58.6% vs. 80.2% in 5 years for graft survival, P < 0.001). Death and graft loss occurred in the first 6 months after diagnosis in one‐third of the patients, 38.8% of them with disseminated disease. Disseminated disease was significantly associated with mortality compared to local disease (41.8% vs. 9.7%, P = 0.035).
Conclusion
TB continues to be a great challenge in KT, especially in developing countries, with significant impact on patient and graft survival. |
| doi_str_mv | 10.1111/tid.12501 |
| format | Article |
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Tuberculosis (TB) is a great challenge in kidney transplantation, and is often associated with high morbidity and mortality. The aim of this study was to evaluate the epidemiology, clinical manifestations, and impact of TB in kidney transplant (KT) recipients.
Methods
We performed a retrospective analysis of a cohort of adult KT recipients from 2000 to 2012, with follow‐up until July 2014.
Results
Among the 1737 KT recipients evaluated, 60 developed TB: a 5% cumulative incidence, and an incidence rate of 589.4 cases/100,000 patient‐years. Median time to diagnosis was 13.4 months, with 40% of the cases occurring in the first year. New‐onset diabetes was significantly associated with post‐transplant TB (P = 0.018). Pulmonary TB represented 78% of the cases, including disseminated disease. Two patients received latent TB treatment and developed active infection. TB was associated with a significant reduction in patient and graft survival (74% vs. 90.2% in 5 years for patient survival, P = 0.001; and 58.6% vs. 80.2% in 5 years for graft survival, P < 0.001). Death and graft loss occurred in the first 6 months after diagnosis in one‐third of the patients, 38.8% of them with disseminated disease. Disseminated disease was significantly associated with mortality compared to local disease (41.8% vs. 9.7%, P = 0.035).
Conclusion
TB continues to be a great challenge in KT, especially in developing countries, with significant impact on patient and graft survival.</description><identifier>ISSN: 1398-2273</identifier><identifier>EISSN: 1399-3062</identifier><identifier>DOI: 10.1111/tid.12501</identifier><identifier>PMID: 26820497</identifier><language>eng</language><publisher>Denmark: Blackwell Publishing Ltd</publisher><subject>Adolescent ; Adult ; Aged ; Aged, 80 and over ; Antitubercular Agents - therapeutic use ; Brazil - epidemiology ; Developing countries ; Epidemiology ; Female ; Graft vs Host Disease ; Humans ; Immunosuppressive Agents - adverse effects ; Immunosuppressive Agents - therapeutic use ; Incidence ; kidney transplant ; Kidney transplantation ; Kidney Transplantation - adverse effects ; latent tuberculosis ; LDCs ; Male ; Middle Aged ; Mortality ; Retrospective Studies ; Risk Factors ; Survival ; Transplants & implants ; Tuberculosis ; Tuberculosis - drug therapy ; Tuberculosis - epidemiology ; Tuberculosis - etiology ; tuberculosis, latent tuberculosis ; Young Adult</subject><ispartof>Transplant infectious disease, 2016-04, Vol.18 (2), p.176-182</ispartof><rights>2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd</rights><rights>2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.</rights><rights>2016 Wiley Periodicals, Inc.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3911-ebd105a9ae72edba0f8a27a3bf108b23c09b507071c8c7173f68a77dac422353</citedby><cites>FETCH-LOGICAL-c3911-ebd105a9ae72edba0f8a27a3bf108b23c09b507071c8c7173f68a77dac422353</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Ftid.12501$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Ftid.12501$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,780,784,1417,27924,27925,45574,45575</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/26820497$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Meinerz, G.</creatorcontrib><creatorcontrib>da Silva, C.K.</creatorcontrib><creatorcontrib>Goldani, J.C.</creatorcontrib><creatorcontrib>Garcia, V.D.</creatorcontrib><creatorcontrib>Keitel, E.</creatorcontrib><title>Epidemiology of tuberculosis after kidney transplantation in a developing country</title><title>Transplant infectious disease</title><addtitle>Transpl Infect Dis</addtitle><description>Background
Tuberculosis (TB) is a great challenge in kidney transplantation, and is often associated with high morbidity and mortality. The aim of this study was to evaluate the epidemiology, clinical manifestations, and impact of TB in kidney transplant (KT) recipients.
Methods
We performed a retrospective analysis of a cohort of adult KT recipients from 2000 to 2012, with follow‐up until July 2014.
Results
Among the 1737 KT recipients evaluated, 60 developed TB: a 5% cumulative incidence, and an incidence rate of 589.4 cases/100,000 patient‐years. Median time to diagnosis was 13.4 months, with 40% of the cases occurring in the first year. New‐onset diabetes was significantly associated with post‐transplant TB (P = 0.018). Pulmonary TB represented 78% of the cases, including disseminated disease. Two patients received latent TB treatment and developed active infection. TB was associated with a significant reduction in patient and graft survival (74% vs. 90.2% in 5 years for patient survival, P = 0.001; and 58.6% vs. 80.2% in 5 years for graft survival, P < 0.001). Death and graft loss occurred in the first 6 months after diagnosis in one‐third of the patients, 38.8% of them with disseminated disease. Disseminated disease was significantly associated with mortality compared to local disease (41.8% vs. 9.7%, P = 0.035).
Conclusion
TB continues to be a great challenge in KT, especially in developing countries, with significant impact on patient and graft survival.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Antitubercular Agents - therapeutic use</subject><subject>Brazil - epidemiology</subject><subject>Developing countries</subject><subject>Epidemiology</subject><subject>Female</subject><subject>Graft vs Host Disease</subject><subject>Humans</subject><subject>Immunosuppressive Agents - adverse effects</subject><subject>Immunosuppressive Agents - therapeutic use</subject><subject>Incidence</subject><subject>kidney transplant</subject><subject>Kidney transplantation</subject><subject>Kidney Transplantation - adverse effects</subject><subject>latent tuberculosis</subject><subject>LDCs</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Mortality</subject><subject>Retrospective Studies</subject><subject>Risk Factors</subject><subject>Survival</subject><subject>Transplants & implants</subject><subject>Tuberculosis</subject><subject>Tuberculosis - drug therapy</subject><subject>Tuberculosis - epidemiology</subject><subject>Tuberculosis - etiology</subject><subject>tuberculosis, latent tuberculosis</subject><subject>Young Adult</subject><issn>1398-2273</issn><issn>1399-3062</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2016</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp10MtKxDAUBuAgiveFLyABN7qo5jJp2qWOl1EGRRiYZUjTU4l2mpqkat_eOqMuBLM5WXzn5_AjdEDJKR3eWbTlKWWC0DW0TXmeJ5ykbH35zxLGJN9COyE8E0JlPso30RZLM0ZGudxGj1etLWFhXe2eeuwqHLsCvOlqF2zAuorg8YstG-hx9LoJba2bqKN1DbYN1riEN6hda5snbFzXRN_voY1K1wH2v-cuml1fzcaTZPpwczs-nyaG55QmUJSUCJ1rkAzKQpMq00xqXlSUZAXjhuSFIJJIajIjqeRVmmkpS21GjHHBd9HxKrb17rWDENXCBgP1cB-4LigqMyp4RgQf6NEf-uw63wzHLRURUtB0UCcrZbwLwUOlWm8X2veKEvVVsxpqVsuaB3v4ndgVCyh_5U-vAzhbgXdbQ_9_kprdXv5EJqsNGyJ8_G5o_6JSyaVQ8_sbdTeX0_locqEm_BMkn5YA</recordid><startdate>201604</startdate><enddate>201604</enddate><creator>Meinerz, G.</creator><creator>da Silva, C.K.</creator><creator>Goldani, J.C.</creator><creator>Garcia, V.D.</creator><creator>Keitel, E.</creator><general>Blackwell Publishing Ltd</general><general>Wiley Subscription Services, Inc</general><scope>BSCLL</scope><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>7QO</scope><scope>7U9</scope><scope>8FD</scope><scope>FR3</scope><scope>H94</scope><scope>K9.</scope><scope>M7N</scope><scope>P64</scope><scope>7X8</scope></search><sort><creationdate>201604</creationdate><title>Epidemiology of tuberculosis after kidney transplantation in a developing country</title><author>Meinerz, G. ; da Silva, C.K. ; Goldani, J.C. ; Garcia, V.D. ; Keitel, E.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3911-ebd105a9ae72edba0f8a27a3bf108b23c09b507071c8c7173f68a77dac422353</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2016</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Antitubercular Agents - therapeutic use</topic><topic>Brazil - epidemiology</topic><topic>Developing countries</topic><topic>Epidemiology</topic><topic>Female</topic><topic>Graft vs Host Disease</topic><topic>Humans</topic><topic>Immunosuppressive Agents - adverse effects</topic><topic>Immunosuppressive Agents - therapeutic use</topic><topic>Incidence</topic><topic>kidney transplant</topic><topic>Kidney transplantation</topic><topic>Kidney Transplantation - adverse effects</topic><topic>latent tuberculosis</topic><topic>LDCs</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Mortality</topic><topic>Retrospective Studies</topic><topic>Risk Factors</topic><topic>Survival</topic><topic>Transplants & implants</topic><topic>Tuberculosis</topic><topic>Tuberculosis - drug therapy</topic><topic>Tuberculosis - epidemiology</topic><topic>Tuberculosis - etiology</topic><topic>tuberculosis, latent tuberculosis</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Meinerz, G.</creatorcontrib><creatorcontrib>da Silva, C.K.</creatorcontrib><creatorcontrib>Goldani, J.C.</creatorcontrib><creatorcontrib>Garcia, V.D.</creatorcontrib><creatorcontrib>Keitel, E.</creatorcontrib><collection>Istex</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Biotechnology Research Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>Technology Research Database</collection><collection>Engineering Research Database</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Algology Mycology and Protozoology Abstracts (Microbiology C)</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>Transplant infectious disease</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Meinerz, G.</au><au>da Silva, C.K.</au><au>Goldani, J.C.</au><au>Garcia, V.D.</au><au>Keitel, E.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Epidemiology of tuberculosis after kidney transplantation in a developing country</atitle><jtitle>Transplant infectious disease</jtitle><addtitle>Transpl Infect Dis</addtitle><date>2016-04</date><risdate>2016</risdate><volume>18</volume><issue>2</issue><spage>176</spage><epage>182</epage><pages>176-182</pages><issn>1398-2273</issn><eissn>1399-3062</eissn><abstract>Background
Tuberculosis (TB) is a great challenge in kidney transplantation, and is often associated with high morbidity and mortality. The aim of this study was to evaluate the epidemiology, clinical manifestations, and impact of TB in kidney transplant (KT) recipients.
Methods
We performed a retrospective analysis of a cohort of adult KT recipients from 2000 to 2012, with follow‐up until July 2014.
Results
Among the 1737 KT recipients evaluated, 60 developed TB: a 5% cumulative incidence, and an incidence rate of 589.4 cases/100,000 patient‐years. Median time to diagnosis was 13.4 months, with 40% of the cases occurring in the first year. New‐onset diabetes was significantly associated with post‐transplant TB (P = 0.018). Pulmonary TB represented 78% of the cases, including disseminated disease. Two patients received latent TB treatment and developed active infection. TB was associated with a significant reduction in patient and graft survival (74% vs. 90.2% in 5 years for patient survival, P = 0.001; and 58.6% vs. 80.2% in 5 years for graft survival, P < 0.001). Death and graft loss occurred in the first 6 months after diagnosis in one‐third of the patients, 38.8% of them with disseminated disease. Disseminated disease was significantly associated with mortality compared to local disease (41.8% vs. 9.7%, P = 0.035).
Conclusion
TB continues to be a great challenge in KT, especially in developing countries, with significant impact on patient and graft survival.</abstract><cop>Denmark</cop><pub>Blackwell Publishing Ltd</pub><pmid>26820497</pmid><doi>10.1111/tid.12501</doi><tpages>7</tpages></addata></record> |
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| subjects | Adolescent Adult Aged Aged, 80 and over Antitubercular Agents - therapeutic use Brazil - epidemiology Developing countries Epidemiology Female Graft vs Host Disease Humans Immunosuppressive Agents - adverse effects Immunosuppressive Agents - therapeutic use Incidence kidney transplant Kidney transplantation Kidney Transplantation - adverse effects latent tuberculosis LDCs Male Middle Aged Mortality Retrospective Studies Risk Factors Survival Transplants & implants Tuberculosis Tuberculosis - drug therapy Tuberculosis - epidemiology Tuberculosis - etiology tuberculosis, latent tuberculosis Young Adult |
| title | Epidemiology of tuberculosis after kidney transplantation in a developing country |
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