The diagnosis of tuberculosis in dialysis patients

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 patien...

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Bibliographic Details
Published in:Saudi journal of kidney diseases and transplantation 2017-11, Vol.28 (6), p.1362-1368
Main Authors: Tiouiri, Hanini, Abd al-Malik, Rim, Beji, Sumayyah, Bin Hamidah, Fathi, Bin Fatimah, Layla, Zuaghi, Muhammad Karim, Barrah, Sana, Jabali, Halah, Beji, Majid, Smaoui, Wided, Mahiri, Salma Nadiyah, Khouja, Nihal, Khidr, Raniya, Rais, Lamya
Format: Article
Language:English
Subjects:
Care and treatment
Diagnosis
Diagnostic tests
Disease control
Drug dosages
Health aspects
Hemodialysis patients
Hospitals
Infections
Infectious diseases
Kidney diseases
Laboratories
Medical diagnosis
Nephrology
Patients
Peritoneal dialysis
Population
Risk factors
Skin
Society
Tuberculosis
التشخيص
المرضى
غسيل الكلى
مرض السل
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Summary: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
ISSN:1319-2442
2320-3838
DOI:10.4103/1319-2442.220882