TB Research

Epidemiological, and management challenges in tuberculosis with chronic kidney disease

Chandra S, Devassy TV

The Indian journal of tuberculosis · 2025-02

Abstract

Background Patients with chronic kidney disease (CKD) are more vulnerable to tuberculosis (TB) because of weakened immune systems, which is a serious health risk, especially in low-to-middle-income nations. Epidemiology CKD patients have a 6.9 to 52.5 times higher risk of developing TB, with dialysis patients at even greater risk. Pathogenesis Impaired cell-mediated immunity, malnutrition, Vitamin-D deficiency, and Zinc deficiency contribute to TB susceptibility in CKD patients. Diagnostic challenges Atypical symptoms, nonspecific presentation, and limited diagnostic tools hinder TB diagnosis in CKD patients. Management Collaborative care and tailored treatment are essential. Anti-TB therapy requires dosing adjustments, careful monitoring, and consideration of comorbid conditions. Conclusion TB in CKD patients presents a complex clinical picture, requiring heightened awareness and multidisciplinary collaboration. Further research is needed to develop CKD-specific TB screening tools, optimal treatment regimens, and improved understanding of TB-CKD pathophysiology.

MeSH terms

  • Humans
  • Tuberculosis
  • Tuberculosis, Pulmonary
  • Antitubercular Agents
  • Renal Dialysis
  • Renal Insufficiency, Chronic