关键词: 活动性肺结核, 慢性肾脏病, 抗结核治疗, 疗效分析

Abstract: Objective To investigate the clinical characteristics and therapeutic efficacy in patients with active pulmonary tuberculosis combined with chronic kidney disease, and to provide references for the diagnosis and treatment of such patients. Method A retrospective analysis was conducted on the clinical data of patients with pulmonary tuberculosis combined with chronic kidney disease who visited the Guangzhou Chest Hospital from January 2020 to December 2024. Result A total of 74 patients were included, with 53 males (71.62%) and 21 females (28.38%), and their ages ranged from 25 to 89 years (median age,64 years). Among them, 14 patients (18.92%) had extrapulmonary tuberculosis. Twenty-four patients (32.43%) received renal replacement therapy. The main clinical manifestations were cough and sputum production. Elevated white blood cell counts were observed in 25 patients (33.78%), anemia in 53 patients (71.62%), and elevated blood urea nitrogen in 61 patients (82.43%). The urine protein was positive in 60 patients (81.08%). Radiological features were mainly patchy infiltrations. All patients received anti-tuberculosis treatment, among which 44 patients showed improvement, with an effective rate of 59.46%.Univariate analysis indicated that patients with elevated white blood cell counts(>9.5×10⁹/L)(40.0% vs 69.39%, χ²=5.931, P=0.015)and those with blood urea nitrogen levels more than three times the upper limit of normal (≥21.3mmol/L) (33.30% vs 67.86%, χ²=6.735, P=0.009) had poorer therapeutic outcomes. Conclusion Patients with active pulmonary tuberculosis combined with chronic kidney disease are mainly middle-aged and elderly males, with a high proportion of extrapulmonary tuberculosis involvement. The overall therapeutic efficacy is relatively poor, and it is associated with white blood cell and blood urea nitrogen levels.

Key words: Tuberculosis, Chronic Kidney Disease, Anti-tuberculosis treatment, Efficacy analysis