关键词: 慢性肾脏病结, 核病, 免疫抑制剂

Abstract: Ｏｂｊｅｃｔｉｖｅ：This retrospective cohort study was to evaluate the clinical characteristics and prognosis of patients with tuberculosis  tuberculosis(TB) secondary to chronic kidney disease(CKD).Ｍｅｔｈｏｄｏｌｏｇｙ：We retrospectively analyzed patients with TB secondary to CKD who were admitted to the National Clinical Research Center of Kidney Diseases,Jinling Hospital from January 2010 to January 2020.We compared the clinical and imaging features at the time of CKD and TB diagnosed,as well as clinical manifestations according to immune status.Ｒｅｓｕｌｔｓ：Among the 71 patients with TB secondary to CKD,who met the inclusion and exclusion standards of this study,605% of them were males,and the first three cause of CKD were  lupus nephritis,membranous nephropathy and podocytosis.64 patients had received an average of 2(1,3) types of immunosuppressive therapy.14 patients were type 2 diabetes mellitus or steroid diabetes mellitus.The age at onset of TB was 3778±160 years.The time from diagnosis of TB to onset of CKD was 17(8,66) months,and from initial symptoms of TB to confirm of TB was 14(9,30) days.Creactive protein was significantly increased,urinary protein and hypoproteinemia were not improved from the onset of CKD to  TB diagnosed.Patients with CD4+T < 300/μl had higher rates of fever and pulmonary miliary nodules and lower rates of pulmonary cavity than those with CD4+T≥300/μl.During followup,the dialysis rate was 3692% and the mortality was 1692%.Ｃｏｎｃｌｕｓｉｏｎ：TB is mostly secondary to patients with CKD who were combine treated with immunosuppressive drugs or complicared  with diabetes,whose urine protein was not remitted.Its clinical and imaging features are related to immune status,and the prognosis is poor.