Tuberculosis in maintenance dialysis patients.
In this investigation, we tried to find the incidence and characteristics of tuberculosis (TB) in dialysis patients previously found only in a small number of cases. We collected the cases of newly diagnosed TB patients in Taiwan during 1997. Simultaneously, all dialysis patients were collected and matched with the TB cases to identify the dialysis patients who had also contracted TB. The annual incidence of the dialysis population was 493.4/100,000, 6.9 times that of the general population (71.1/100,000). The annual incidence for the male dialysis population was 573.3, the incidence was 479.2 for the female dialysis population. The incidence for the general population was 97.1 and 43.7/100,000, respectively. Although the 1-year mortality rate due to TB (1.7 vs. 1.9%, p > 0.05) was similar in both populations, the non-TB mortality was much higher in the dialysis population than that in the general population (25.6 vs. 11.1%, p < 0.05). Finally, the 1-year mortality rate of dialysis patients with TB is 3.3 times higher than that in dialysis patients without TB (27.3 vs. 8.3%, p < 0.05). The findings suggest that uremia modifies the behavior of TB, jeopardizes female and younger dialysis patients, poses a higher risk of extrapulmonary dissemination, and predicts a higher overall mortality.
Chou
K J
KJ
Department of Medicine, Section of Nephrology, Kaohsiung Veterans General Hospital, National Yang-Ming University School of Medicine, Kaohsiung, Taiwan. kjchou@isca.vghks.gov.tw
Fang
H C
HC
Bai
K J
KJ
Hwang
S J
SJ
Yang
W C
WC
Chung
H M
HM
D000367:Age Factors; D005260:Female; D006801:Humans; D008297:Male; D006435:Renal Dialysis; D013624:Taiwan / Q000453:epidemiology; D014376:Tuberculosis / Q000150:complications / Q000453:epidemiology* / Q000401:mortality; D014511:Uremia / Q000150:complications / Q000453:epidemiology / Q000628:therapy