Non-tuberculous mycobacterial infections in patients with end-stage renal disease: prevalence, risk factors, and mortality

Eszter Toth, Jennifer L. Waller, Wendy B. Bollag, Budder Siddiqui, Azeem Mohammed, Mufaddal Kheda, Sandeep Padala, Lufei Young, Stephanie L. Baer, Sarah Tran

Research output: Contribution to journalArticlepeer-review

Abstract

Non-tuberculous mycobacterial (NTM) disease has increased in prevalence in the USA, however, little is known on NTM in the population with end-stage renal disease (ESRD). Thus, we investigated patients with ESRD to determine risk factors for NTM disease and mortality. We queried the United States Renal Data System from 2005 to 2015 using International Classification of Diseases (ICD)-9/ICD-10 codes to identify NTM and risk factors. Logistic regression was used to examine the association of risk factors with NTM and Cox proportional hazards modeling was used to assess the association of NTM with mortality. Of 1,068,634 included subjects, 3232 (0.3%) individuals were identified with any NTM diagnosis. Hemodialysis versus peritoneal dialysis (OR=0.10, 95% CI=0.08 to 0.13) was protective for NTM, whereas black (OR=1.27, 95% CI=1.18 to 1.37) or other race compared with white race (OR=1.39, 95% CI=1.21 to 1.59) increased the risk of NTM. HIV (OR=15.71, 95% CI=14.24 to 17.33), history of any transplant (OR=4.25, 95% CI=3.93 to 4.60), kidney transplant (OR=3.00, 95% CI=2.75 to 3.27), diabetes (OR=1.32, 95% CI=1.23 to 1.43), rheumatologic disease (OR=1.92, 95% CI=1.77 to 2.08), and liver disease (OR=2.09, 95% CI=1.91 to 2.30) were associated with increased risk for NTM diagnosis. In multivariable analysis, there was a significant increase in mortality with any NTM diagnosis (HR=1.83, 95% CI=1.76 to 1.91, p≤0.0001). Controlling for relevant demographic and clinical risk factors, there was an increased risk of mortality associated with any diagnosis of NTM. Early diagnosis and treatment of NTM infection may improve survival in patients with ESRD.

Original languageEnglish (US)
Article numberjim-2022-002462
JournalJournal of investigative medicine : the official publication of the American Federation for Clinical Research
Early online dateOct 6 2022
DOIs
StateE-pub ahead of print - Oct 6 2022

Keywords

  • bacterial infections
  • kidney failure, chronic
  • kidney transplantation
  • United States

ASJC Scopus subject areas

  • Biochemistry, Genetics and Molecular Biology(all)

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