Increased incidence of tuberculosis in patients undergoing hemodialysis.
Tuberculosis was diagnosed in 26 patients (6 females and 20 males) undergoing maintenance hemodialysis, with an incidence of 23.6%. Infection was characterized clinically by a very insidious onset, the main symptoms being anorexia, loss of weight and low-grade fever, a very high sedimentation rate and lymphocytes predominant in the peripheral circulation, pleural and peritoneal fluids. Pulmonary tuberculosis was seen in 18 patients (70%), 10 of whom presented with pleural effusions. There were extrapulmonary presentations in 8 of the 26 patients (30%). Most of the patients developed the disease about 1 year from the start of their dialysis treatment. With early therapy all patients survived their tuberculosis disease and no recurrence was seen in up to 5 years of follow-up. Despite earlier reports of high mortality, we suggest that awareness of the increased incidence of tuberculosis in dialysis patients, together with its unusual presentation and consequent early diagnosis, results in a very good prognosis.
Cengiz
K
K
Department of Nephrology, Ondokuz Mayis University School of Medicine, Samsun, Turkey.
D000328:Adult; D000368:Aged; D000904:Antibiotics, Antitubercular / Q000009:adverse effects / Q000627:therapeutic use; D000995:Antitubercular Agents / Q000009:adverse effects / Q000627:therapeutic use; D004977:Ethambutol / Q000009:adverse effects / Q000627:therapeutic use; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D010529:Peritoneal Cavity / Q000382:microbiology; D011379:Prognosis; D011859:Radiography; D006435:Renal Dialysis / Q000009:adverse effects*; D012293:Rifampin / Q000009:adverse effects / Q000627:therapeutic use; D014397:Tuberculosis, Pulmonary / Q000097:blood / Q000000981:diagnostic imaging / Q000209:etiology*
D000904:Antibiotics, Antitubercular; D000995:Antitubercular Agents; D004977:Ethambutol; D012293:Rifampin