Characteristics and outcomes of end-stage renal disease patients with active tuberculosis followed in intensive care units.
Tuberculosis (TB) remains a common problem in patients with chronic renal failure. In intensive care units, misdiagnosis or delayed diagnosis of TB is common. Therefore, a description of characteristics of active TB in patients with renal failure followed in intensive care units is important to reduce mortality and transmission of the disease. This study was performed to describe the characteristics of patients with renal failure admitted to the intensive care units and having active TB and evaluate predictive factors for in hospital mortality. The hospital records of 24 patients (11 women, 13 men) having ESRD and TB between 2001-2006 were reviewed. Clinical, radiological, and laboratory data on admission were recorded. Possible parameters contributing to in-hospital mortality were obtained from the medical records. In-hospital mortality rate was 66.6%. Factors associated with mortality were decreased partial pressure of oxygen and malnutrition. Fever was reported in 8 patients and hemoptysis was reported in 3 patients. Eight patients had consolidation on chest radiograph, while 4 had normal findings Seventeen patients had pulmonary involvement, and 11 had extra pulmonary involvement. The mortality rate in TB patients followed in intensive care units is high, with 3 factors contributing to in-hospital mortality. Clinicians should consider active TB in renal failure patients being followed in the intensive care unit, even when results of a chest radiograph are normal especially in patients with unexplained poor general health or respiratory failure.
Ulasli
Sevinc Sarinc
SS
Department of Pulmonary Diseases, Baskent University, Faculty of Medicine, Ankara, Turkey. sevincsarinc@gmail.com
Ulubay
Gaye
G
Arslan
Nevra Gullu
NG
Sezer
Siren
S
Akcay
Sule
S
Eyuboglu
Fusun Oner
FO
Haberal
Mehmet
M
D018562:Disease Transmission, Infectious / Q000706:statistics & numerical data; D005260:Female; D005500:Follow-Up Studies; D017052:Hospital Mortality / Q000639:trends; D006801:Humans; D007362:Intensive Care Units; D007676:Kidney Failure, Chronic / Q000150:complications* / Q000175:diagnosis / Q000401:mortality; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D006435:Renal Dialysis; D012189:Retrospective Studies; D012307:Risk Factors; D014397:Tuberculosis, Pulmonary / Q000150:complications* / Q000175:diagnosis / Q000401:mortality; D014421:Turkey / Q000453:epidemiology