TB testing for people with diabetes and kidney disease

Why are people living with diabetes and kidney disease at higher risk for TB?

People living with diabetes and chronic kidney disease (CKD) have weakened immune systems, which makes it harder for their bodies to control tuberculosis (TB) infection. Hyperglycemia in diabetes reduces immune responses, and defense against TB is further compromised by uremia and dialysis-related factors in CKD. These immune deficits increase the risk for TB infection and also the risk of progression to active TB disease. 

People with renal failure or requiring dialysis face worse TB outcomes

TB disease is more severe and harder to diagnose in people with kidney failure. These patients often experience atypical or extrapulmonary TB presentations and require treatment with a modified anti-TB drug regimen. Kidney failure patients and people on dialysis also require close monitoring for potential complications from drug interactions, toxicity and reduced medication clearance. 

Diabetes and TB – an emerging co-epidemic

Diabetes is one of the most common medical risk factors in relation to TB disease (1). People living with kidney failure, which is often caused by advanced diabetes mellitus, face a higher prevalence of TB infection, a higher risk of TB reactivation and higher mortality during TB treatment (2–4).

Why is early TB testing important for people with diabetes, CKD or on dialysis?

Co-presentation of kidney and tuberculosis diseases has a profound negative impact on patient outcomes. For example, a recent report found that nearly 40% of people with kidney failure and TB disease in the US die before TB infection is detected or before TB treatment can be completed (7). 

Thankfully, timely detection of TB infection and appropriate preventative therapy can help prevent TB disease. Approximately 80% of TB disease among patients with kidney disease arises from reactivation of existing TB infection (4). With early diagnosis and treatment, the prognosis for TB in dialysis patients is often good. 

QuantiFERON-TB Gold Plus: Reliable TB infection detection

Detecting and treating TB infection can prevent TB disease in diabetes patients. However, the tuberculin skin test (TST) has significant limitations. For example, a study of US CDC data found that people living with TB disease and kidney failure showed twice the prevalence of a false-negative TST result (39%) compared to people with TB disease but without kidney failure (20%) (4).

QuantiFERON-TB Gold Plus can help improve patient and practice outcomes by providing faster, more accurate results than the century-old tuberculin skin test. It’s an accurate, single-visit test that’s unaffected by the BCG vaccine.