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KMID : 0882420100790040387
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Korean Journal of Medicine
2010 Volume.79 No. 4 p.387 ~ p.393
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Comparative analysis of the clinical features and prognosis of extrapulmonary tuberculosis according to the renal function
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Choi Bo-Kyung
Lee Hee-Sun
Hwang In-Hye
Shin Kyung-Hwa
Choi Moon-Ki
Choi Bo-Kwang
Ahn Kang-Hee
Nam Hyeong-Seok
Hwang Jong-Min
Seong Eun-Young
Song Sang-Heon
Lee Soo-Bong
Kwak Ihm-Soo
Seol Hee-Yun
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Abstract
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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, ≥ 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.
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KEYWORD
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Tuberculosis, Glomerular filtration rate, Treatment outcome
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