Tuberculosis and chronic kidney disease: an emerging global syndemic

Kidney Int. 2016 Jul;90(1):34-40. doi: 10.1016/j.kint.2016.01.034. Epub 2016 May 10.


The link between chronic kidney disease (CKD) and tuberculosis (TB) has been known for more than 40 years, but the interaction between these 2 diseases is still poorly understood. Dialysis and renal transplant patients appear to be at a higher risk of TB, in part related to immunosuppression along with socioeconomic, demographic, and comorbid factors. Meanwhile, TB screening and diagnostic test performance is suboptimal in the CKD population, and there is limited evidence to guide protocols. Given the increasing prevalence of CKD in TB endemic areas, a merging of CKD and TB epidemics could have significant public health implications, especially in low- to middle-income countries such as India and China, that are experiencing rapid increases in CKD prevalence and account for more than one-third of global TB prevalence. To begin addressing TB-CKD, a clear understanding of the relationship between these 2 conditions needs to be established, and consistent, evidence-based screening and treatment guidelines need to be developed.

Keywords: chronic kidney disease; dialysis; global burden of disease; kidney transplant; tuberculosis.

Publication types

  • Review
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Antitubercular Agents / adverse effects
  • Antitubercular Agents / therapeutic use
  • China / epidemiology
  • Clinical Trials as Topic
  • Comorbidity
  • Endemic Diseases / prevention & control*
  • Evidence-Based Medicine
  • Humans
  • Immunosuppression / adverse effects
  • India / epidemiology
  • Kidney Transplantation / adverse effects*
  • Mass Screening
  • Nephritis, Interstitial / chemically induced
  • Practice Guidelines as Topic
  • Prevalence
  • Renal Dialysis / adverse effects*
  • Renal Insufficiency, Chronic / complications*
  • Renal Insufficiency, Chronic / epidemiology*
  • Renal Insufficiency, Chronic / therapy
  • Risk Factors
  • Tuberculosis / complications*
  • Tuberculosis / diagnosis
  • Tuberculosis / epidemiology*
  • Tuberculosis / therapy


  • Antitubercular Agents