Kidney transplantation and tuberculosis: A clinical and epidemiological analysis in Brazil

Abstract

Introduction and objectives

Tuberculosis is an infectious disease that can compromise the success of kidney transplantation. The objective of the present study was to identify and assess the clinical and epidemiological differences of kidney transplantation subjects according to tuberculosis status in a Brazilian state.

Methods

The records of 843 subjects were analyzed retrospectively in a case–control protocol. We performed crude and adjusted analyses according to tuberculosis diagnosis after kidney transplantation.

Results

The average age among subjects who underwent kidney transplantation were 40 ± 14 years. Approximately 60% of the patients were males, and 57% were non-Caucasian. Tuberculosis was diagnosed in 13 kidney transplantation recipients (1.54%; 95% CI: 0.71–2.38%). The adjusted analysis revealed that patients with a history of tuberculosis were 41 times more likely to develop tuberculosis after kidney transplantation than were other patients (OR = 40.71; 95% CI: 2.54–651.84). The number of infectious episodes (OR = 1.35; 95% CI: 1.10–1.67) and the use of sirolimus during initial immunosuppression also increased this risk (OR = 41.40; 95% CI: 2.59–660.31).

Conclusion

The implementation of follow-up screening and procedures is necessary to avoid compromising the effectiveness of kidney transplantation by developing diseases such as tuberculosis. Follow-ups are also important for the development of new technologies to improve the diagnosis and management of the disease in these patients.