PMID- 32818551
OWN - NLM
STAT- MEDLINE
DCOM- 20210510
LR  - 20210510
IS  - 1523-6838 (Electronic)
IS  - 0272-6386 (Linking)
VI  - 77
IP  - 5
DP  - 2021 May
TI  - Latent Tuberculosis Therapy Outcomes in Dialysis Patients: A Retrospective 
      Cohort.
PG  - 696-703
LID - S0272-6386(20)30897-0 [pii]
LID - 10.1053/j.ajkd.2020.06.017 [doi]
AB  - RATIONALE & OBJECTIVES: Maintenance dialysis patients are at an increased risk 
      for active tuberculosis (TB). In 2012, British Columbia, Canada, began 
      systematically screening maintenance dialysis patients for latent TB infection 
      (LTBI) and treating people with evidence of LTBI when appropriate. We examined 
      LTBI treatment outcomes and compared treatment outcomes before and after rollout 
      of the systematic screening program. STUDY DESIGN: Retrospective cohort study. 
      SETTING & PARTICIPANTS: The study comprised 365 people in British Columbia, 
      Canada, initiating at least 90 days of dialysis from January 1, 2001, to May 31, 
      2017, and starting LTBI therapy: 290 (79.5%) people in the recent cohort and 75 
      (20.5%) in the historical cohort. People starting LTBI therapy from January 1, 
      2012, onward were classified as the recent cohort, whereas people starting LTBI 
      therapy before January 1, 2012, were classified as the historical cohort. 
      EXPOSURE: Systematic LTBI screening and therapy. OUTCOMES: Proportion of people 
      who experience grade 3 to 5 adverse events (AEs) or any grade rash and 
      end-of-treatment outcomes. ANALYTICAL APPROACH: Outcomes were reported using 
      descriptive statistics. 2-sample test of proportions using chi(2) distribution was 
      used to test for statistical significance between the recent and historical 
      cohorts. RESULTS: 298 (81.6%) people successfully completed LTBI therapy. The 
      proportion of people experiencing a grade 3 to 4 AE or any grade rash was 21.1%. 
      Most AEs were related to gastrointestinal events, general malaise, or pruritus 
      that resulted in regimen changes. 2 (0.5%) people were hospitalized for AEs 
      related to LTBI therapy. No significant difference was found between the recent 
      and historical cohorts in all outcomes of interest. No grade 5 AEs (deaths) were 
      attributed to LTBI therapy. LIMITATIONS: Retrospective data and generalizability 
      outside low-TB-burden settings. CONCLUSIONS: Our findings suggest that a high 
      proportion of people receiving maintenance dialysis can complete LTBI therapy. 
      The rate of grade 3 to 4 AEs was high and associated with frequent medication 
      changes during therapy. LTBI therapy in maintenance dialysis may be safe but 
      requires close monitoring.
CI  - Crown Copyright (c) 2020. Published by Elsevier Inc. All rights reserved.
FAU - Chiang, Leslie Y
AU  - Chiang LY
AD  - British Columbia Centre for Disease Control, Vancouver, Canada; Provincial Health 
      Services Authority, Vancouver, Canada.
FAU - Baumann, Brett
AU  - Baumann B
AD  - University of British Columbia, Vancouver, Canada.
FAU - Romanowski, Kamila
AU  - Romanowski K
AD  - British Columbia Centre for Disease Control, Vancouver, Canada; Provincial Health 
      Services Authority, Vancouver, Canada; University of British Columbia, Vancouver, 
      Canada.
FAU - Kumar, Divjot
AU  - Kumar D
AD  - University of British Columbia, Vancouver, Canada.
FAU - Campbell, Jonathon R
AU  - Campbell JR
AD  - McGill University, Quebec, Canada.
FAU - Djurdjev, Ognjenka
AU  - Djurdjev O
AD  - Provincial Health Services Authority, Vancouver, Canada; British Columbia Renal, 
      Vancouver, Canada.
FAU - Morshed, Muhammad
AU  - Morshed M
AD  - Provincial Health Services Authority, Vancouver, Canada; University of British 
      Columbia, Vancouver, Canada; British Columbia Centre for Disease Control Public 
      Health Laboratory, Vancouver, Canada.
FAU - Sekirov, Inna
AU  - Sekirov I
AD  - Provincial Health Services Authority, Vancouver, Canada; University of British 
      Columbia, Vancouver, Canada; British Columbia Centre for Disease Control Public 
      Health Laboratory, Vancouver, Canada.
FAU - Cook, Victoria J
AU  - Cook VJ
AD  - British Columbia Centre for Disease Control, Vancouver, Canada; Provincial Health 
      Services Authority, Vancouver, Canada; University of British Columbia, Vancouver, 
      Canada.
FAU - Levin, Adeera
AU  - Levin A
AD  - Provincial Health Services Authority, Vancouver, Canada; University of British 
      Columbia, Vancouver, Canada; British Columbia Renal, Vancouver, Canada.
FAU - Johnston, James C
AU  - Johnston JC
AD  - British Columbia Centre for Disease Control, Vancouver, Canada; Provincial Health 
      Services Authority, Vancouver, Canada; University of British Columbia, Vancouver, 
      Canada. Electronic address: james.johnston@bccdc.ca.
LA  - eng
PT  - Journal Article
DEP - 20200817
PL  - United States
TA  - Am J Kidney Dis
JT  - American journal of kidney diseases : the official journal of the National Kidney 
      Foundation
JID - 8110075
RN  - 0 (Antitubercular Agents)
RN  - 1W306TDA6S (Rifabutin)
RN  - 8059-24-3 (Vitamin B 6)
RN  - V83O1VOZ8L (Isoniazid)
RN  - VJT6J7R4TR (Rifampin)
SB  - IM
MH  - Aged
MH  - Antitubercular Agents/*therapeutic use
MH  - Chemical and Drug Induced Liver Injury/etiology
MH  - Cohort Studies
MH  - Exanthema/chemically induced
MH  - Female
MH  - Gastrointestinal Diseases/chemically induced
MH  - Humans
MH  - Isoniazid/therapeutic use
MH  - Kidney Failure, Chronic/complications/*therapy
MH  - Latent Tuberculosis/complications/diagnosis/*drug therapy
MH  - Male
MH  - Mass Screening
MH  - Middle Aged
MH  - Pruritus/chemically induced
MH  - *Renal Dialysis
MH  - Retrospective Studies
MH  - Rifabutin/therapeutic use
MH  - Rifampin/therapeutic use
MH  - Treatment Outcome
MH  - Vitamin B 6/therapeutic use
OTO - NOTNLM
OT  - LTBI therapy
OT  - TB registry
OT  - Tuberculosis (TB)
OT  - adverse events
OT  - chronic kidney disease (CKD)
OT  - dialysis
OT  - drug intolerance
OT  - end-stage renal disease (ESRD)
OT  - hepatotoxicity
OT  - isoniazid
OT  - latent tuberculosis infection (LTBI)
OT  - treatment completion rate
OT  - treatment outcomes
EDAT- 2020/08/21 06:00
MHDA- 2021/05/11 06:00
CRDT- 2020/08/21 06:00
PHST- 2019/09/19 00:00 [received]
PHST- 2020/06/20 00:00 [accepted]
PHST- 2020/08/21 06:00 [pubmed]
PHST- 2021/05/11 06:00 [medline]
PHST- 2020/08/21 06:00 [entrez]
AID - S0272-6386(20)30897-0 [pii]
AID - 10.1053/j.ajkd.2020.06.017 [doi]
PST - ppublish
SO  - Am J Kidney Dis. 2021 May;77(5):696-703. doi: 10.1053/j.ajkd.2020.06.017. Epub 
      2020 Aug 17.