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Tuberculosis in children undergoing continuous ambulatory peritoneal dialysis
M Ekim1, N Tümer, S Bakkaloğlu
1Department of Pediatric Nephrology, Ankara University Faculty of Medicine, Ankara, Turkey.
Insights
Tuberculosis (TB) reactivation is a risk for children on continuous ambulatory peritoneal dialysis (CAPD). Early TB investigation is crucial for pediatric CAPD patients, especially in high-prevalence areas.
Area of Science:
- Nephrology
- Infectious Diseases
- Pediatrics
Background:
- Global increase in tuberculosis (TB) incidence.
- Chronic renal failure impairs cellular immunity, increasing TB reactivation risk.
- Continuous ambulatory peritoneal dialysis (CAPD) is a treatment for pediatric chronic renal failure.
Observation:
- Seventy pediatric patients underwent CAPD between 1989-1997.
- Four patients (5.7%) developed TB during CAPD treatment.
- TB presentations included pulmonary TB and extrapulmonary TB osteomyelitis.
Findings:
- All TB patients received antituberculous drug therapy.
- Two patients with pulmonary TB were cured.
- Two patients showed symptom improvement but died due to unknown causes.
Implications:
- Children on CAPD require vigilant TB screening, particularly those with unexplained cough or fever.
- High TB prevalence areas necessitate proactive investigation in pediatric CAPD populations.
- Understanding TB risks in immunocompromised pediatric patients is critical for effective management.
Abstract:
The incidence of tuberculosis (TB) is increasing worldwide. Due to an impairment of cellular immunity, patients with chronic renal failure are susceptible to reactivation of TB. Seventy patients were treated by continuous ambulatory peritoneal dialysis (CAPD) in our pediatric nephrology department during the years 1989-1997. TB was diagnosed in 4 patients, representing 5.7% of all CAPD patients in our department. One patient had extrapulmonary (TB osteomyelitis) and the others had pulmonary TB. All patients were treated with antituberculous drugs. Two patients with pulmonary TB were cured. Symptoms improved in the other 2 patients but they died at home for unknown reasons. We recommend that all children in regions of high prevalence of TB should be investigated for TB, especially if they have a cough or fever of unknown etiology.