Incidence and risk factors for tuberculosis in patients with chronic kidney disease in Singapore

Introduction The authors aim to determine tuberculosis (TB) incidence and ascertain risk factors for TB in patients with stage 5 chronic kidney disease (CKD5) in the Singapore population. Method A retrospective cohort study of all stage CKD5 patients registered in Singapore's renal registry who developed active pulmonary and extra-pulmonary TB between 2012 and 2021, after their CKD5 diagnosis. Results TB incidence among CKD5 patients was significantly higher compared to the general Singapore population, ranging from 279 to 630 per 100,000 CKD5 population over the period from 2012 to 2021, versus 32.6 to 41.1 per 100,000 general population during the same period. In univariable comparisons, statistically significant risk factors for development of TB disease in CKD5 patients were: male sex (odds ratio [OR] 1.66, 95% confidence interval [CI] 1.3-2.12, P Conclusion CKD5 patients have an increased risk of developing TB, particularly when certain risk factors are present, such as male sex or receiving dialysis. Clinicians should maintain a high degree of suspicion for TB in CKD5 patients with compatible clinical symptoms.