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Background <p>The association between kidney function and tuberculosis treatment outcomes remains uncertain.</p> Methods <p>We analyzed a multicenter prospective cohort of adults with rifampicin-susceptible pulmonary tuberculosis enrolled in Korea between 2019 and 2021. Kidney function was categorized using baseline estimated glomerular filtration rate (eGFR) calculated with the 2021 CKD-EPI creatinine equation and grouped as preserved (eGFR ≥ 60 mL/min/1.73&#xa0;m²) and reduced (eGFR &lt; 60 mL/min/1.73&#xa0;m²) kidney function. An additional analysis evaluated severely reduced kidney function (eGFR &lt; 30 mL/min/1.73&#xa0;m²). The primary endpoint was unfavorable outcome, defined as loss-to-follow-up, treatment failure, death, still-on-treatment, transfer to another treatment unit, or recurrence, analyzed using multivariable logistic regression. The secondary endpoint was failure to complete treatment within 9 months of initiation, analyzed by Cox proportional hazards model. All models adjusted for prespecified covariates, with age and sex included in all models.</p> Results <p>Among 966 participants, 89 (9%) had reduced kidney function. Unfavorable outcomes were more frequent among participants with reduced kidney function (41% vs. 19%; <i>P</i> &lt; 0.001). After multivariable adjustment, reduced kidney function was independently associated with unfavorable outcomes (adjusted odds ratio [aOR], 2.46; 95% confidence interval [CI], 1.49–4.02). Severely reduced kidney function showed higher odds of unfavorable outcome (aOR, 5.52; 95% CI, 2.42–13.01). Reduced kidney function was associated with failure to complete treatment within 9 months (adjusted hazard ratio, 3.07; 95% CI, 1.69–5.59).</p> Conclusions <p>Reduced kidney function was independently associated with unfavorable TB treatment outcomes. Patients with impaired kidney function at the time of tuberculosis diagnosis may require closer clinical monitoring during treatment.</p>

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Association between reduced kidney function and tuberculosis treatment outcomes

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年3月26日

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  • Sangjun Park,
  • Hyung Woo Kim,
  • Eung Gu Lee,
  • Yeonhee Park,
  • Sung Soo Jung,
  • Jin Woo Kim,
  • Jee Youn Oh,
  • Heayon Lee,
  • Seung Hoon Kim,
  • Sun-Hyung Kim,
  • Jiwon Lyu,
  • Sun Jung Kwon,
  • Yun-Jeong Jeong,
  • Do Jin Kim,
  • Hyeon-Kyoung Koo,
  • Ganghee Chae,
  • Yoolwon Jeong,
  • Ju Sang Kim,
  • Jinsoo Min

摘要

Background

The association between kidney function and tuberculosis treatment outcomes remains uncertain.

Methods

We analyzed a multicenter prospective cohort of adults with rifampicin-susceptible pulmonary tuberculosis enrolled in Korea between 2019 and 2021. Kidney function was categorized using baseline estimated glomerular filtration rate (eGFR) calculated with the 2021 CKD-EPI creatinine equation and grouped as preserved (eGFR ≥ 60 mL/min/1.73 m²) and reduced (eGFR < 60 mL/min/1.73 m²) kidney function. An additional analysis evaluated severely reduced kidney function (eGFR < 30 mL/min/1.73 m²). The primary endpoint was unfavorable outcome, defined as loss-to-follow-up, treatment failure, death, still-on-treatment, transfer to another treatment unit, or recurrence, analyzed using multivariable logistic regression. The secondary endpoint was failure to complete treatment within 9 months of initiation, analyzed by Cox proportional hazards model. All models adjusted for prespecified covariates, with age and sex included in all models.

Results

Among 966 participants, 89 (9%) had reduced kidney function. Unfavorable outcomes were more frequent among participants with reduced kidney function (41% vs. 19%; P < 0.001). After multivariable adjustment, reduced kidney function was independently associated with unfavorable outcomes (adjusted odds ratio [aOR], 2.46; 95% confidence interval [CI], 1.49–4.02). Severely reduced kidney function showed higher odds of unfavorable outcome (aOR, 5.52; 95% CI, 2.42–13.01). Reduced kidney function was associated with failure to complete treatment within 9 months (adjusted hazard ratio, 3.07; 95% CI, 1.69–5.59).

Conclusions

Reduced kidney function was independently associated with unfavorable TB treatment outcomes. Patients with impaired kidney function at the time of tuberculosis diagnosis may require closer clinical monitoring during treatment.