title: Tuberculosis in dialysis patients: a nine-year retrospective analysis.
abstract: BACKGROUND
  Diagnosis of tuberculosis (TB) among dialysis patients may be difficult because of increased frequency of extra-pulmonary presentations, atypical clinical manifestations, and non-specific symptoms. This study aimed to investigate the spectrum of clinical presentations and outcome in dialysis patients during a nine-year period.
  
  
  METHODS
  A total of 651 patients undergoing hemodialysis (HD) and peritoneal dialysis (PD) for at least three months in our unit between 2001 and 2010 were studied. Dialysis and follow-up were performed in our tertiary care center located in the eastern region of Turkey. Diagnosis of TB was established by combining clinical, radiological, biochemical, microbiological, and histological findings. Choice of anti-TB drug used, the results of therapy, and patient outcome were noted.
  
  
  RESULTS
  Out of 651 dialysis patients studied, 322 (49.4%) were on PD and the remainder on HD (50.6%). Twenty-six (4%) of the 651 dialysis patients were diagnosed with TB (15 PD, 11 HD), 5 of whom were diagnosed by microbiological assessment, 9 by pathological assessment, and 12 by clinical and radiological findings. Mean age at diagnosis was 41.5 ± 16.5 years and the female/male ratio was 1.18. Three patients had a history of pulmonary TB. Extra-pulmonary involvement was observed in 17 (65.4%) patients. All patients were treated with rifampicin isoniazid, ethambutol, pyrazinamide and pyridoxine. Four patients died during the study.
  
  
  CONCLUSIONS
  TB occurred in dialysis patients and extra-pulmonary TB was more commonly identified than pulmonary TB. Tuberculous lymphadenitis was the most frequent form of extra-pulmonary TB in our cohort.
authors.affiliation: Division of Nephrology, Sisli Etfal Research and Education Hospital, Istanbul, Turkey. akadir.unsal@gmail.com
authors.forename: Abdulkadir
authors.initials: A
authors.lastname: Unsal
authors.forename: Elbis
authors.initials: E
authors.lastname: Ahbap
authors.forename: Taner
authors.initials: T
authors.lastname: Basturk
authors.forename: Yener
authors.initials: Y
authors.lastname: Koc
authors.forename: Tamer
authors.initials: T
authors.lastname: Sakaci
authors.forename: Ayse
authors.initials: A
authors.lastname: Sinangil Arar
authors.forename: Hasan
authors.initials: H
authors.lastname: Kayabasi
authors.forename: Mustafa
authors.initials: M
authors.lastname: Sevinc
mesh_terms: D000328:Adult; D000995:Antitubercular Agents / Q000627:therapeutic use; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010530:Peritoneal Dialysis; D006435:Renal Dialysis; D012189:Retrospective Studies; D016896:Treatment Outcome; D014376:Tuberculosis / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology* / Q000473:pathology; D014421:Turkey / Q000453:epidemiology
chemical_list: D000995:Antitubercular Agents