title: The risk factors and laboratory diagnostics for post renal transplant tuberculosis: a case-control, country-wide study on definitive cases.
abstract: BACKGROUND
  Tuberculosis (TB) is an important cause of morbidity and mortality in renal transplant recipients and, because of its infrequency and the lack of medical awareness, it is usually misdiagnosed. This study was carried out to determine frequency and weight of multiple risk factors for post kidney transplantation TB.
  
  
  METHODS
  A total of 44 cases (0.3%), out of 12,820 patients from 12 major kidney transplantation centers in Iran from 1984 to 2003, were compared with 184 healthy transplant subjects who were transplanted by the same surgical team.
  
  
  RESULTS
  The mean age of cases and controls was 37.7 (13-63) and 35.6 (8-67) years (P=0.3), respectively. The mean duration of pre-transplantation hemodialysis was 30.3 (3-168) months in cases and 18.2 (1-180) months in controls (P=0.03). A positive past history of TB was detected in 2 cases and 1 control (P=0.3). The mean doses of initial and maintenance immunosuppressive drugs in cases and controls were not significantly different. A total of 25 cases (56.8%) and 60 controls (32.6%) had rejection before diagnosis of TB (P=0.004; OR=2.7, CI(95%): 1.3-5.6).
  
  
  CONCLUSIONS
  To our knowledge, this is the first study that demonstrated an increase in the risk of post-transplant TB by increasing the duration of pre-transplant hemodialysis and the number of post-transplant rejection episodes as 2 immunocompromised states. Further study is needed to clarify our new findings, specifically in relation to different immunosuppressive regimens.
authors.affiliation: Urology/Nephrology Research Center, Tehran, Iran. basiri@unrc.ir
authors.forename: A
authors.initials: A
authors.lastname: Basiri
authors.forename: S M
authors.initials: SM
authors.lastname: Hosseini-Moghaddam
authors.forename: N
authors.initials: N
authors.lastname: Simforoosh
authors.forename: B
authors.initials: B
authors.lastname: Einollahi
authors.forename: M
authors.initials: M
authors.lastname: Hosseini
authors.forename: A
authors.initials: A
authors.lastname: Foirouzan
authors.forename: F
authors.initials: F
authors.lastname: Pourrezagholi
authors.forename: M
authors.initials: M
authors.lastname: Nafar
authors.forename: M A
authors.initials: MA
authors.lastname: Zargar
authors.forename: G
authors.initials: G
authors.lastname: Pourmand
authors.forename: A
authors.initials: A
authors.lastname: Tara
authors.forename: H
authors.initials: H
authors.lastname: Mombeni
authors.forename: M R
authors.initials: MR
authors.lastname: Moradi
authors.forename: A Taghizadeh
authors.initials: AT
authors.lastname: Afshar
authors.forename: H R
authors.initials: HR
authors.lastname: Gholamrezaee
authors.forename: A
authors.initials: A
authors.lastname: Bohlouli
authors.forename: H
authors.initials: H
authors.lastname: Nezhadgashti
authors.forename: A
authors.initials: A
authors.lastname: Akbarzadehpasha
authors.forename: E
authors.initials: E
authors.lastname: Ahmad
authors.forename: M
authors.initials: M
authors.lastname: Salehipour
authors.forename: M
authors.initials: M
authors.lastname: Yazdani
authors.forename: A
authors.initials: A
authors.lastname: Nasrollahi
authors.forename: N
authors.initials: N
authors.lastname: Oghbaee
authors.forename: R Esmaeeli
authors.initials: RE
authors.lastname: Azad
authors.forename: Z
authors.initials: Z
authors.lastname: Mohammadi
authors.forename: Z
authors.initials: Z
authors.lastname: Razzaghi
mesh_terms: D000293:Adolescent; D000328:Adult; D016022:Case-Control Studies; D005260:Female; D006084:Graft Rejection; D006801:Humans; D007492:Iran / Q000453:epidemiology; D016030:Kidney Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D006435:Renal Dialysis; D012307:Risk Factors; D014184:Transplantation, Homologous / Q000009:adverse effects; D014376:Tuberculosis / Q000453:epidemiology* / Q000382:microbiology; D014397:Tuberculosis, Pulmonary / Q000453:epidemiology* / Q000382:microbiology