Mycobacterial Infections in Patients With Chronic Kidney Disease and Kidney Transplantation

Adv Chronic Kidney Dis. 2019 Jan;26(1):35-40. doi: 10.1053/j.ackd.2018.09.004.

Abstract

Patients with chronic kidney disease have impaired immunity that increases their risk of infection. Increased incidence of mycobacterial infections, in particular Mycobacterium tuberculosis, is described in patients undergoing hemodialysis and peritoneal dialysis as well as after kidney transplantation in low-prevalence and high-prevalence settings. Diagnosis of this infection can be challenging because of atypical presentations that may lead to treatment delay and, consequently, increased mortality; however, recent advances in molecular testing have improved diagnostic accuracy. It is imperative to try to identify those patients at increased risk and offer adequate prophylaxis. There are controversies and insufficient data regarding treatment agents, duration, and dosages. Most studies in nontuberculous mycobacteria are based on case series and retrospective studies.

Keywords: Chronic kidney disease; Infectious disease; Kidney transplant; Mycobacterium tuberculosis (TB); Nontuberculous mycobacteria (NTM).

Publication types

  • Review

MeSH terms

  • Antitubercular Agents / therapeutic use*
  • Humans
  • Interferon-gamma Release Tests
  • Kidney Failure, Chronic / epidemiology
  • Kidney Failure, Chronic / therapy*
  • Kidney Transplantation*
  • Latent Tuberculosis / diagnosis
  • Latent Tuberculosis / drug therapy*
  • Latent Tuberculosis / epidemiology
  • Mycobacterium Infections, Nontuberculous / diagnosis
  • Mycobacterium Infections, Nontuberculous / drug therapy*
  • Mycobacterium Infections, Nontuberculous / epidemiology
  • Peritoneal Dialysis
  • Peritonitis, Tuberculous / diagnosis
  • Peritonitis, Tuberculous / drug therapy
  • Peritonitis, Tuberculous / epidemiology
  • Renal Dialysis
  • Renal Insufficiency, Chronic / epidemiology
  • Tuberculosis / diagnosis
  • Tuberculosis / drug therapy
  • Tuberculosis / epidemiology
  • Tuberculosis, Lymph Node / diagnosis
  • Tuberculosis, Lymph Node / drug therapy
  • Tuberculosis, Lymph Node / epidemiology

Substances

  • Antitubercular Agents