Active Tuberculosis in Chronic Kidney Disease: Frequency, Clinical Spectrum, and Stage-Wise Pattern in an Observational Study

Abstract

Background: Tuberculosis Remains Clinically Important In Patients With Chronic Kidney Disease Because Uremia, Malnutrition, Diabetes, And Dialysis-Related Exposure May Weaken Host Defence And Delay Recognition Of Disease.

Objective: To Determine The Frequency, Phenotype, And Stage-Wise Pattern Of Active TB Among Patients With CKD And To Explore Selected Clinical Correlates.

Materials and Methods: This Observational Cross-Sectional Analysis Included 60 CKD Patients Enrolled Between March 2025 And February 2026. Variables Included CKD Stage, Egfr, Diabetes, Hypertension, TB Status, TB Type, Smoking, BMI, Serum Albumin, And Haemoglobin. Exact Tests And Mann-Whitney U Testing Were Used Because Active TB Events Were Few.

Results: Active TB Was Documented In 6/60 Patients (10.0%; 95% CI: 3.8-20.5). Pulmonary, Extra pulmonary, And Combined TB Were Equally Represented (2 Cases Each). Stage 5D Showed the Highest Numerical Frequency (2/5, 40.0%), Compared With 4/55 (7.3%) In Non-Stage 5D Patients (P=0.074). Active TB Patients Had Lower Mean Egfr, Serum Albumin, And Haemoglobin Than Those Without TB, Although None Reached Statistical Significance.

Conclusion: Active TB Was Not Rare In This CKD Cohort And Appeared Numerically Concentrated In Dialysis-Dependent Disease. The Findings Support Stage-Sensitive TB Vigilance In CKD Care, Particularly When Advanced CKD, Hypoalbuminaemia, Anemia, Or Dialysis Transition Is Present.