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Nutritional Adequacy and Latent Tuberculosis Infection in End-Stage Renal Disease Patients

Background: Latent tuberculosis infection (LTBI) is prevalent in end-stage renal disease (ESRD) patients. The risk of tuberculosis activation is also high. The appropriate LTBI screening and treatment is required in this population. Meanwhile, whether hemodialysis adequacy is associated with LTBI in...

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Autores principales: Baek, Seung Don, Jeung, Soomin, Kang, Jae-Young
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6835669/
https://www.ncbi.nlm.nih.gov/pubmed/31561559
http://dx.doi.org/10.3390/nu11102299
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author Baek, Seung Don
Jeung, Soomin
Kang, Jae-Young
author_facet Baek, Seung Don
Jeung, Soomin
Kang, Jae-Young
author_sort Baek, Seung Don
collection PubMed
description Background: Latent tuberculosis infection (LTBI) is prevalent in end-stage renal disease (ESRD) patients. The risk of tuberculosis activation is also high. The appropriate LTBI screening and treatment is required in this population. Meanwhile, whether hemodialysis adequacy is associated with LTBI in the ESRD population is unclear. In this study, we aimed to investigate the association between hemodialysis adequacy and LTBI in ESRD patients. Methods: In the present cross-sectional study, we reviewed all outpatient-based ESRD patients in our artificial kidney room. Interferon gamma release assay (IGRA) was used for the diagnosis of LTBI. Clinical variables including nutritional adequacy (i.e., normalized protein catabolic rate, nPCR) and dialysis adequacy (i.e., Kt/V) were compared between IGRA-positive and IGRA-negative patients. Results: A total of 90 patients were enrolled, of which 20 (22.2%) had positive IGRA results using the QuantiFERON-TB method. Old fibrotic changes and nPCR (g/kg/day) were significantly different between IGRA-positive and IGRA-negative patients (both p < 0.005), while serum albumin and Kt/V were comparable (p = 0.429 and p = 0.590, respectively). Normalized PCR remained to be significant in a multivariate logistic regression analysis (adjusted hazard ratio, 0.911 (0.861–0.963); p = 0.001). The cutoff nPCR value less than 0.87 g/kg/day had an adjusted hazard ratio of 7.74 (1.77–33.74) for predicting LTBI. Patients with nPCR value less than 0.87 g/kg/day were older and had lower serum hemoglobin, albumin, calcium concentration, and Kt/V levels than those with nPCR value greater than 0.87 g/kg/day. Conclusions: Nutritional adequacy, especially when assessing nPCR value, was associated with LTBI, while dialysis adequacy was not associated with LTBI.
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spelling pubmed-68356692019-11-25 Nutritional Adequacy and Latent Tuberculosis Infection in End-Stage Renal Disease Patients Baek, Seung Don Jeung, Soomin Kang, Jae-Young Nutrients Article Background: Latent tuberculosis infection (LTBI) is prevalent in end-stage renal disease (ESRD) patients. The risk of tuberculosis activation is also high. The appropriate LTBI screening and treatment is required in this population. Meanwhile, whether hemodialysis adequacy is associated with LTBI in the ESRD population is unclear. In this study, we aimed to investigate the association between hemodialysis adequacy and LTBI in ESRD patients. Methods: In the present cross-sectional study, we reviewed all outpatient-based ESRD patients in our artificial kidney room. Interferon gamma release assay (IGRA) was used for the diagnosis of LTBI. Clinical variables including nutritional adequacy (i.e., normalized protein catabolic rate, nPCR) and dialysis adequacy (i.e., Kt/V) were compared between IGRA-positive and IGRA-negative patients. Results: A total of 90 patients were enrolled, of which 20 (22.2%) had positive IGRA results using the QuantiFERON-TB method. Old fibrotic changes and nPCR (g/kg/day) were significantly different between IGRA-positive and IGRA-negative patients (both p < 0.005), while serum albumin and Kt/V were comparable (p = 0.429 and p = 0.590, respectively). Normalized PCR remained to be significant in a multivariate logistic regression analysis (adjusted hazard ratio, 0.911 (0.861–0.963); p = 0.001). The cutoff nPCR value less than 0.87 g/kg/day had an adjusted hazard ratio of 7.74 (1.77–33.74) for predicting LTBI. Patients with nPCR value less than 0.87 g/kg/day were older and had lower serum hemoglobin, albumin, calcium concentration, and Kt/V levels than those with nPCR value greater than 0.87 g/kg/day. Conclusions: Nutritional adequacy, especially when assessing nPCR value, was associated with LTBI, while dialysis adequacy was not associated with LTBI. MDPI 2019-09-26 /pmc/articles/PMC6835669/ /pubmed/31561559 http://dx.doi.org/10.3390/nu11102299 Text en © 2019 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Baek, Seung Don
Jeung, Soomin
Kang, Jae-Young
Nutritional Adequacy and Latent Tuberculosis Infection in End-Stage Renal Disease Patients
title Nutritional Adequacy and Latent Tuberculosis Infection in End-Stage Renal Disease Patients
title_full Nutritional Adequacy and Latent Tuberculosis Infection in End-Stage Renal Disease Patients
title_fullStr Nutritional Adequacy and Latent Tuberculosis Infection in End-Stage Renal Disease Patients
title_full_unstemmed Nutritional Adequacy and Latent Tuberculosis Infection in End-Stage Renal Disease Patients
title_short Nutritional Adequacy and Latent Tuberculosis Infection in End-Stage Renal Disease Patients
title_sort nutritional adequacy and latent tuberculosis infection in end-stage renal disease patients
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6835669/
https://www.ncbi.nlm.nih.gov/pubmed/31561559
http://dx.doi.org/10.3390/nu11102299
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