The diagnosis of tuberculosis in dialysis patients

Autor: Hela Jebali, Sana Barrah, Lamia Rais, Rania Kheder, Nihal Khouja, Salma Nadia Mhiri, Majed Beji, Rim Abdelmalek, Hanene Tiouiri, Wided Smaoui, Soumaya Beji, Fethi Ben Hmida, Lilia Ben Fatma, Mohamed Karim Zouaghi
Jazyk: angličtina
Rok vydání: 2017
Předmět:
Zdroj: Saudi Journal of Kidney Diseases and Transplantation, Vol 28, Iss 6, Pp 1362-1368 (2017)
Druh dokumentu: article
ISSN: 1319-2442
DOI: 10.4103/1319-2442.220882
Popis: The incidence of tuberculosis (TB) is high in patients undergoing chronic dialysis than it is in the general population. The diagnosis of TB is often difficult and extrapulmonary involvement is predominant. This study investigates the spectrum of clinical presentations and outcome in dialysis patients during a nine-year period. TB was diagnosed in 41 patients. Anti-TB drugs, adverse effects of therapy, and outcome were noted. Thirty-eight patients (92.6%) were on hemodialysis and three were on peritoneal dialysis (7.3%). The mean age at diagnosis was 50.8 years and the male/female ratio was 1.16. Four patients had a history of pulmonary TB. Extrapulmonary involvement was observed in 32 (78 %) patients. The bacteriological confirmation was made in 41.46% and histological confirmation was made in 26.83%, and in the rest, the diagnosis was retained on the criterion presumption. Nineteen patients (46.34%) developed adverse effects of antitubercular drugs. Eight patients (19.51%) died during the study from TB or adverse effects of treatment. Low urea reduction ratio and female sex were associated with poor prognosis in our study. The clinical manifestations of TB in patients on dialysis are quite nonspecific, making timely diagnosis difficult, and delaying the initiation of curative treatment, which is a major determinant of the outcome.
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