Risk predictors of pulmonary tuberculosis in patients with chronic kidney disease / 公共卫生与预防医学

ABSTRACT

Objective The risk prediction factors of patients with chronic kidney disease (CKD) complicated with pulmonary tuberculosis were analyzed, and the risk prediction model was constructed to provide theoretical basis for the prevention and treatment of pulmonary tuberculosis in patients with CKD. Methods Stratified sampling was used to randomly select 289 patients with CKD admitted to our hospital as the investigation objects. According to whether patients complicated with tuberculosis, they were divided into experimental group (n=65, CKD complicated with tuberculosis) and control group (n=224, CKD). Univariate analysis and logistic regression were used to analyze the influencing factors of pulmonary tuberculosis in PATIENTS with CKD. According to the regression results, the risk prediction model of pulmonary tuberculosis in CKD patients was established, and the ROC curve was used to predict the efficacy of the model. Results Among 289 patients with CKD, 65 cases (22.49%) had pulmonary tuberculosis. Chest X-ray showed 54 cases of infiltrating pulmonary tuberculosis, 5 cases of voiding pulmonary tuberculosis, 4 cases of caseous pneumonia and 2 cases of tuberculous pleurisy. The main clinical manifestations of CKD complicated with pulmonary tuberculosis were low fever, poor appetite and fatigue in 36 cases, cough and expectoration in 18 cases, high fever in 9 cases and pleural effusion in 2 cases. Mycobacterium tuberculosis culture was positive in 23 cases (35.38%). There were no significant differences in age, CKD stage, past tuberculosis history, low immunity, malnutrition, dialysis treatment, anemia and hypoproteinemia between 2 groups (P-(0.496+0.839×(low immunity)+ 0.892×(malnutrition)+ 1.247×(dialysis)]; ROC curve was used to analyze the predictive efficacy of the regression model. The results showed that the AUC of pulmonary tuberculosis predicted by the risk prediction model was 0.779, 95%Cl(0.668-0.889) for CKD patients. Conclusion The risk of tuberculosis in CKD is higher,low immunity, malnutrition, dialysis treatment of CKD patients is high risk for tuberculosis, according to the specific situation of the patients, take targeted measures to prevention, can reduce the risk of tuberculosis in patients with CKD.