title: Tuberculosis in renal transplant patients: the experience of a single center in Medellín-Colombia, 2005-2013.
abstract: BACKGROUND
  Tuberculosis is a common opportunistic infection in renal transplant patients.
  
  
  OBJECTIVE
  To obtain a clinical and laboratory description of transplant patients diagnosed with tuberculosis and their response to treatment during a period ranging from 2005 to 2013 at the Pablo Tobón Uribe Hospital.
  
  
  METHODS
  Retrospective and descriptive study.
  
  
  RESULTS
  In 641 renal transplants, tuberculosis was confirmed in 12 cases. Of these, 25% had a history of acute rejection, and 50% had creatinine levels greater than 1.5 mg/dl prior to infection. The disease typically presented as pulmonary (50%) and disseminated (33.3%). The first phase of treatment consisted of 3 months of HZRE (isoniazid, pyrazinamide, rifampicin and ethambutol) in 75% of the cases and HZME (isoniazid, pyrazinamide, moxifloxacin and ethambutol) in 25% of the cases. During the second phase of the treatment, 75% of the cases received isoniazid and rifampicin, and 25% of the cases received isoniazid and ethambutol. The length of treatment varied between 6 and 18 months. In 41.7% of patients, hepatotoxicity was associated with the beginning of anti-tuberculosis therapy. During a year-long follow-up, renal function remained stable, and the mortality rate was 16.7%.
  
  
  CONCLUSIONS
  Tuberculosis in the renal transplant population studied caused diverse nonspecific symptoms. Pulmonary and disseminated tuberculosis were the most frequent forms and required prolonged treatment. Antituberculosis medications had a high toxicity and mortality. This infection must be considered when patients present with a febrile syndrome of unknown origin, especially during the first year after renal transplant.
authors.affiliation: Pablo Tobón Uribe Hospital.
authors.forename: Lina Maria Serna
authors.initials: LM
authors.lastname: Higuita
authors.affiliation: Pablo Tobón Uribe Hospital.
authors.forename: John Fredy
authors.initials: JF
authors.lastname: Nieto-Ríos
authors.affiliation: Pontifical Bolivarian University.
authors.forename: Salomon
authors.initials: S
authors.lastname: Daguer-Gonzalez
authors.affiliation: Pablo Tobón Uribe Hospital.
authors.forename: Catalina
authors.initials: C
authors.lastname: Ocampo-Kohn
authors.affiliation: Pablo Tobón Uribe Hospital.
authors.forename: Arbey
authors.initials: A
authors.lastname: Aristizabal-Alzate
authors.affiliation: Pablo Tobón Uribe Hospital.
authors.forename: Catalina
authors.initials: C
authors.lastname: Velez-Echeverri
authors.affiliation: Pablo Tobón Uribe Hospital.
authors.forename: Juan Jose
authors.initials: JJ
authors.lastname: Vanegas-Ruiz
authors.affiliation: Pablo Tobón Uribe Hospital.
authors.forename: Isabel
authors.initials: I
authors.lastname: Ramirez-Sanchez
authors.affiliation: Pablo Tobón Uribe Hospital.
authors.forename: Jhon Jairo Zuleta
authors.initials: JJ
authors.lastname: Tobon
authors.affiliation: Pablo Tobón Uribe Hospital.
authors.forename: Gustavo Adolfo
authors.initials: GA
authors.lastname: Zuluaga-Valencia
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D003105:Colombia; D005260:Female; D006801:Humans; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000175:diagnosis* / Q000188:drug therapy; D012189:Retrospective Studies; D013997:Time Factors; D014376:Tuberculosis / Q000175:diagnosis* / Q000188:drug therapy; D055815:Young Adult