Update of the mechanism and characteristics of tuberculosis in chronic kidney disease: Review article

Summary The risk of tuberculosis (TB) is significantly increased in patients with chronic kidney disease (CKD), which is closely related to hyperparathyroidism, malnutrition and oxidative stress as well as immune deficiency in patients with end-stage renal disease (ESRD). Vitamin D deficiency and gender bias are independent risk factors. In the TB screening and diagnosis test of CKD, interferon-gamma release assays (IGRA), including T‑SPOT.TB test (T-SPOT) and QuantiFERON-TB Gold In-Tube (QFT-GIT) have been available. Many studies have found that they are more sensitive and specific than tuberculin skin test (TST). At present, IGRA has been used to study various types of immunocompromised patients. For CKD patients with TB, the choice and dosage of anti-TB drugs need to be reconsidered. Weekly treatment with rifapentin (RFT) and isoniazid (INH) for 3 months is an effective treatment for latent tuberculosis infection (LTBI) in hemodialysis (HD) patients. Therefore, in this review we discuss CKD and TB, its pathogenesis, clinical features, diagnosis and treatment advancements.