Clinical comparisons of 1,498 chronic renal failure patients with and without tuberculosis.
OBJECTIVE
To investigate the clinical characteristics of chronic renal failure (CRF) patients suffering from tuberculosis.


METHODS
Clinical materials from CRF inpatients in our department suffering from tuberculosis from 1997 to 2003 were investigated and compared with similar data from tuberculosis patients without CRF in Chongqing City (China) during the same period.


RESULTS
Of the 1,498 tested CRF inpatients, 71 suffered from tuberculosis, more than half of which suffered from atypical type V tuberculosis (lesion spot uncertain). The incidence of tuberculosis in the CRF inpatients (4740/100,000) was significantly higher than that in Chongqing City (151/100,000; P<.001). We found an inverse association between renal function and tuberculosis; the worse the renal function, the higher the tuberculosis incidence. CRF patients suffering from tuberculosis had fewer positive antituberculosis-antibody and purified protein-derivative tests (12.7% and 15.5%, respectively) than did tuberculosis patients without CRF (72.1% and 58.1%, respectively; P<.05). In CRF patients with tuberculosis, the two-thirds dosage antituberculosis drug treatment was effective. Twelve cases had good outcome after a 1-year course of antituberculosis treatment and then kidney transplantation. In contrast, 4 patients who received less than half a year of antituberculosis treatment died after kidney transplantation, in association with relapsed tuberculosis.


CONCLUSIONS
CRF patients are susceptible to tuberculosis, especially to atypical tuberculosis outside the lung. Thus, antituberculosis treatment might be necessary in CRF patients found to be suffering from chronic fevers of unknown origin. Furthermore, it appears to be safe for patients with CRF plus tuberculosis to receive kidney transplantation after 1 year of antituberculosis treatment.
Yuan
Fa-huan
FH
Department of Nephrology, Xinqiao Hospital, Chongqing, PR China.
Guang
Li-xia
LX
Zhao
Sheng-jia
SJ
D000328:Adult; D000995:Antitubercular Agents / Q000627:therapeutic use; D016022:Case-Control Studies; D002681:China / Q000453:epidemiology; D005260:Female; D006801:Humans; D015994:Incidence; D007676:Kidney Failure, Chronic / Q000150:complications* / Q000453:epidemiology / Q000628:therapy; D016030:Kidney Transplantation; D008297:Male; D010530:Peritoneal Dialysis; D006435:Renal Dialysis; D014376:Tuberculosis / Q000150:complications* / Q000188:drug therapy / Q000453:epidemiology
D000995:Antitubercular Agents