DETECTION OF LATENT TUBERCULOSIS IN PATIENTS WITH CHRONIC KIDNEY DISEASE ON RENAL REPLACEMENT THERAPY USING INTERFERON GAMMA RELEASE ASSAY

Abstract

Introduction: Latent tuberculosis is presence of immunological response to tubercular antigens without clinical features. Chronic kidney disease patients are more susceptible to developing active tuberculosis from latent tuberculosis infection and are at higher risk of mortality and morbidity.It has been shown that rate of active tuberculosis have been estimated to be 10 times higher than in general population, so our study aims at detecting latent tuberculosis in chronic kidney disease patients who are on maintenance hemodialysis using interferon gamma release assay. Method of collection of data: At RL Jalappa Hospitals and Research Centre, Kolar, patients diagnosed with CKD who are on hemodialysis were randomly chosen. It is cross sectional observational study with a sample size of 60 subjects. After ruling out active tuberculosis , 5 ml of blood in lithium heparin tube is sent for enzyme linked immunosorbent assay for interferon gamma after harvesting the plasma, along with complete blood count , renal function test , serum electrolytes. Results: In the study 27 ( 45%) subjects out of 60 turned out to be positive for interferon gamma release assay and 30 ( 55%) turned out to be negative. The mean age of patients who tested positive is 49.93 years , with a standard deviation of 14.7 years. Mean Hba1c for subjects turned positive is 7.73%. Alcohol consumption has a statistically significant association with positive interferon gamma release assay ( p value – 0 ) . Smoking did not have effect on igra positivity . Conclusions: This study highlights significant pevalenc of latent tuberculosis among patients with chronic kidney disease undergoing renal replacement therapy. Using interferon gamma xvi release assay we were able to detect latent tuberculosis in substantial amount of chronic kidney patients underscores the importance of routine screening .