Risk of active tuberculosis infection in kidney transplantation recipients: a matched comparative nationwide cohort study.

Abstract

Large-scale evidence comparing the risk of mycobacterium tuberculosis (TB) between kidney transplant (KT) recipients and dialysis patients is warranted. This is a nationwide retrospective cohort study based on the claims database of South Korea where a moderate prevalence of TB is reported. We included incident KT recipients from 2011 to 2015 and compared their active-TB risks with 1:1 matched dialysis and general population control groups, respectively. The risk of incident active-TB was assessed by multivariable Cox regression. Associations between active-TB and post-transplant death or death-censored graft failure were investigated. The number of matched subjects included in each of the study groups was 7,462. The KT group showed a significantly higher risk of active-TB than the general population group (HR 3.39 [1.88-6.10]), whereas it showed a similar risk to that of the dialysis group (HR 0.98 [0.73-1.31]). In KT patients, active-TB was a significant risk factor for both death (HR 2.33 [1.24-4.39]) and death-censored graft failure (HR 2.26 [1.39-3.67]). Although KT recipients may not have to burden the additional risk of active-TB when compared to dialysis patients in recent medicine, active-TB should not be overlooked as it is associated with a worse prognosis in post-transplant patients.