Tuberculosis Prevalence in Kidney Transplant Recipients: Systematic Review and Meta-Analysis

Abstract

Introduction: The tuberculosis (TB) prevalence in transplant recipients is greater than in a general population and is mainly determinate by epidemiologic risk of each country. Thus the aim is to realize a systematic review and meta-analysis of TB prevalence in renal transplant recipients. Methods: The texts were identified by search in electronic bases and reference lists review with the terms: tuberculosis and renal transplantation. Then were screened by the authors according to inclusion and exclusion criteria, and the studies' data selected were extracted according to pre-established chart. In the analysis was determined the pooled prevalence of tuberculosis in renal transplant recipients, was realized heterogeneity test (Q Test) and a sensitivity analysis. We also conducted univariated and multivariated analysis by meta-regression. Results: We screened 253 papers, reviewed 86 abstracts and from these 63 complete texts were analyzed of which 41 studies (73,808 subjects) made in countries with high (18 studies), middle (14 studies) and low (9 studies) TB prevalence in the general population. The pooled prevalence of TB in renal transplant recipients was 2,500 per 100,000 (95% CI = 2,200 - 2,900). In the final model of the meta-regression the variables year of publication, sample size and country's general prevalence remained associated with the prevalence of tuberculosis in renal transplant recipients. Conclusions: Despite of the limitations of the study were found a wide variability in tuberculosis rates in renal transplant recipients and there is strong suggestion of the relationship of TB general prevalence with this rates.