Tuberculosis in hemodialysis.
Chronic uremia puts patients at increased risk of infectious complications, in particular, tuberculosis. In this prospective study, we analyzed the clinical, paraclinical, and therapeutic features as well as outcome for all patients on chronic hemodialysis with tuberculosis from January 2010 through August 2012. Sixty-one patients were admitted for bacterial infections, 23% of them for tuberculosis. Fever was present in 71% of cases, and CRP elevated in all cases. The tuberculin skin test was positive in only 2 of 9 cases, and Mycobacterium tuberculosis isolated in 2 of 10 cases. Histological evidence was obtained in 7 of 9 cases. Plain radiographs and computed tomography evoked tuberculosis. The location was extrapulmonary in 71% of cases. Chemotherapy for tuberculosis was based on a quadruple therapy for 10 patients and triple therapy for 3. The outcome was favorable in 11 patients and fatal for 3. Tuberculosis is much more common in hemodialysis patients than in the general population. The telltale signs are nonspecific. Prognosis is closely linked to early diagnosis and treatment.
Service de néphrologie, dialyse et transplantation rénale de l'hôpital militaire d'instruction Mohammed V, avenue des Forces armées royales, BP 10100, Hay Riad, Rabat, Maroc.
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El Amrani
Service de néphrologie, dialyse, et transplantation rénale de l'hôpital militaire d'instruction Mohammed V, Rabat, Maroc.
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Asserraji
Service de néphrologie, dialyse et transplantation rénale de l'hôpital militaire d'instruction Mohammed V, avenue des Forces armées royales, BP 10100, Hay Riad, Rabat, Maroc.
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Bahadi
Service de néphrologie, dialyse et transplantation rénale de l'hôpital militaire d'instruction Mohammed V, avenue des Forces armées royales, BP 10100, Hay Riad, Rabat, Maroc.
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El Kabbaj
Service de néphrologie, dialyse et transplantation rénale de l'hôpital militaire d'instruction Mohammed V, avenue des Forces armées royales, BP 10100, Hay Riad, Rabat, Maroc.
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Benyahia
D000293:Adolescent; D000328:Adult; D000368:Aged; D000904:Antibiotics, Antitubercular / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D009018:Morocco / Q000453:epidemiology; D009894:Opportunistic Infections / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology; D011446:Prospective Studies; D006435:Renal Dialysis; D014376:Tuberculosis / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology*; D055815:Young Adult
D000904:Antibiotics, Antitubercular
Morocco; antibacillar chemotherapy; hemodialysis; immunodepression; tuberculosis